Suprapubic Cystostomy Overview

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.

Female Bladder and Urethra © 2009 Nucleus Medical Media, Inc.

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

You should also talk to your doctor about your medicines. If this is not an emergency situation, you may be asked to stop taking some medicines up to one week before the procedure, like:

• Aspirin or other anti-inflammatory drugs

• Blood thinners, like warfarin (Coumadin)

• Clopidogrel (Plavix)

Your doctor may ask you to take certain medicines before surgery.

In the days leading up to the surgery:

• Arrange for a ride home from the hospital.

• You may need to avoid eating for eight hours before the surgery.

• If instructed by your doctor, drink only clear liquids (eg, water, clear juices, tea) before the surgery. 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

Once anesthesia has numbed the area, the doctor will use ultrasound or other imaging tools to locate the bladder. Next, he will insert a needle 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 prevents pain during the procedure. You will be given pain medicine to ease pain and soreness after the surgery.

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 medicine

• Teach you how to care for your catheter

At Home

When you return home, do the following to help ensure a smooth recovery:

• Take medicines as directed.

• Avoid lifting heavy objects for two weeks.

• Drink plenty of fluids (8-10 glasses per day).

• Do not drive or have sex until your doctor tells you that it is safe to do so.

• Follow the guidelines for changing the catheter and collection bag.

• Keep the stoma site clean and dry:

• Clean the incision site as directed.
• Use a soft wash cloth to gently wipe the incision area.
• Change dressings daily, or more as directed.

• Be sure to follow your doctor’s instructions.

RESOURCES:

American Urological Association
http://www.auanet.org/

National Institute of Diabetes and Digestive and Kidney Diseases
http://www2.niddk.nih.gov/

CANADIAN RESOURCES:

Canadian Urological Association
http://www.cua.org/

Health Canada
http://www.hc-sc.gc.ca/index-eng.php

References:

Aguilera PA, Choi T, Durham BA. Ultrasound-guided suprapubic cystostomy catheter placement in the emergency department. J Emerg Med. 2004;26(3):319-21.

Danbury Hospital Patient Education. 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 August 11, 2010.

Percutaneous suprapubic cystostomy. In: Roberts: Clinical Procedures in Emergency Medicine. 5th ed. Philadelphia, PA: Saunders Elsevier; 2009:chap 55.

Smith N. How to care for a suprapubic catheter. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81 . Updated July 2010. Accessed August 20, 2010.