Suprapubic Cystostomy
En Español (Spanish Version)

Definition
Suprapubic cystostomy is a procedure to help drain the bladder (organ that collects and holds urine). A tube called a catheter, which leads out of the lower abdomen, is inserted to drain the bladder.

Bladder and Urethra (Female)

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Reasons for Procedure
This procedure is done if you cannot urinate and a catheter cannot be passed through your urethra to help you urinate. The urethra is where urine passes out of the body from the bladder. Urine may not be able pass through the urethra due to:

  • Narrowing of the urethra
  • Other blockage due to:
    • Kidney stones
    • Inflammation
    • Infection
    • Injury
    • Prostate disease (in men)
The procedure may also be done if you need to:

  • Avoid damaging the urethra
  • Have surgery on the urethra or nearby structures
  • Have a catheter in your body long-term
Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Damage to the bowel or other surrounding structures
  • Need for a repeat procedure
  • Infection
  • Bleeding
  • Blood clots
  • Anesthesia reaction
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

Your risk of complications may also increase if you have:

  • Bleeding disorders
  • Taken medications that reduce blood clotting
  • Had previous abdominal surgery
  • Bladder cancer
What to Expect
Prior to Procedure
Your doctor may do the following:

  • Physical exam
  • Imaging, blood, and urine tests
  • Talk about the anesthesia being used and the potential risks
Talk to your doctor about any medications, herbs, or supplements you are taking. You may be asked to stop taking some medications up to one week before the procedure.

In the days before the surgery:

  • Arrange for a ride home from the hospital.
  • You may need to avoid eating for 8 hours before the surgery.
  • If instructed by your doctor, drink only clear liquids (such as water, clear juices, tea). You may be asked to drink extra fluids to fill the bladder.
Note: These steps may not be possible in an emergency situation.

Anesthesia
Local anesthesia may be used with or without sedation. You will not have any pain during the procedure.

Description of the Procedure
After anesthesia has numbed the area, the doctor will locate the bladder using imaging tools such as ultrasound if needed. Next, a needle will be inserted through your lower abdomen and into your bladder. A wire will then be guided through the needle into the bladder to prepare the site for a catheter. A special catheter will be placed into the bladder over the wire. The catheter will be sutured in place. A balloon may be inflated to keep the catheter in place. Afterward, the opening made in the skin (called a stoma) will be covered with gauze.

How Long Will It Take?
10-45 minutes

How Much Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay
You will either stay in the hospital overnight or go home the same day.

Post-procedure Care
At the Hospital
The hospital staff will:

  • Monitor your recovery
  • Help you to eat and move around again
  • Give you pain medication
  • Teach you how to care for your catheter
During your stay, the hospital staff will take steps to reduce your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered
There are also steps you can take to reduce your chances of infection such as:

  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incisions
At Home
You will have to restrict your activities while you recover. Follow instructions on cleaning the stoma. It will help prevent infection. The hospital staff will teach you how to change the catheter and collection bag. Your doctor may advise medication, such as pain relievers or antibiotics.

Call Your Doctor
After you leave the hospital, call your doctor if any of the following occurs:

  • Pain or cramps
  • Redness or soreness around the catheter site
  • Catheter fails to drain
  • Catheter falls outs
  • Changes in frequency, odor, appearance, or volume of urine
  • Signs of infection, including fever or chills
  • Bloody urine
If you think you have an emergency, call for medical help right away.




RESOURCES:
National Institute of Diabetes and Digestive and Kidney Diseases

Urology Care Foundation

CANADIAN RESOURCES:
Canadian Urological Association


References:
Aguilera PA, Choi T, et al. Ultrasound-guided suprapubic cystostomy catheter placement in the emergency department. J Emerg Med. 2004;26(3):319-321.

Care of a suprapubic cystostomy. Danbury Hospital Patient Education website. Available at: http://www.danburyhospital.org/en/Patient-and-Visitor-Information/Information-Guides/~/media/Files/Patient%20Education/patiented-english/pdf_Surgery/SuprapubicCystostomyCare.ashx. Accessed October 19, 2012.

Last Reviewed January 2015



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