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A suprapubic cystostomy or suprapubic catheter (SPC) [1] (also known as a vesicostomy or epicystostomy) is a surgically created connection between the urinary bladder and the skin used to drain urine from the bladder in individuals with obstruction of normal urinary flow. The connection does not go through the abdominal cavity.
If medical treatment does not reduce a patient's urinary symptoms, a TURP may be considered following a careful examination of the prostate or bladder through a cystoscope. If TURP is contraindicated, a urologist may consider a simple prostatectomy, in and out catheters, or a supra-pubic catheter to help a patient void urine effectively. [3]
Use of alpha-blockers can provide relief of urinary retention following de-catheterization for both men and women. [9] [10] In case, if catheter can't be negotiated, suprapubic puncture can be done with lumbar puncture needle.
Men with acute prostatitis complicated by urinary retention are best managed with a suprapubic catheter or intermittent catheterization. Lack of clinical response to antibiotics should raise the suspicion of an abscess and prompt an imaging study such as a transrectal ultrasound (TRUS).
Common indications for urinary catheterization include acute or chronic urinary retention (which can damage the kidneys) from conditions such as benign prostatic hyperplasia, orthopedic procedures that may limit a patient's movement, the need for accurate monitoring of input and output (such as in an ICU), urinary incontinence that may compromise the ability to heal wounds, and the effects of ...
Urethral dilatation and catheter placement. This can be performed in the Emergency Department, a practitioner's office or an operating room. The advantage of this approach is that the urethra may remain patent for a period of time after the dilation, though long-term success rates are low.
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