An audit of suprapubic catheter insertion performed by a urological nurse specialist

Sinha, Mithilesh Kumar; Matippa, Prasanna; Krishnamoorthy, Venkatesh

doi:10.4103/0970-1591.109977

Cited by 3 publications

(8 citation statements)

References 3 publications

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“…[1], who reported a rate of 2.4% in 2006. More recent studies demonstrate a significantly lower risk of bowel injury of <1% [4–12] but it is difficult to make direct comparisons between these studies due to differences in study design and populations [13].…”

Section: Discussionmentioning

confidence: 99%

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Suprapubic catheterisation: a study of 1000 elective procedures

et al. 2022

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Objectives To investigate the risks and long‐term outcomes of suprapubic catheter (SPC) insertion in a population predominantly with spinal cord injury. Materials and Methods We used the theatre database at the National Spinal Injuries Centre in Stoke Mandeville Hospital to identify 1000 consecutive SPC insertions from 1998 to 2015. We retrospectively analysed all records for these patients. Results Follow‐up ranged from 4 weeks to 16.45 years (median 3.3 years). Either cystoscopy‐guided suprapubic puncture (Lawrence Add‐a‐Cath trochar) or a direct incision onto a urethral sound (Lowsley retractor) followed by cystoscopy was used for 98% of insertions. Complications graded as Clavien–Dindo IIIb or higher occurred in 0.6% of patients. Return to theatre was necessary in 0.4%, including three laparotomies due to bleeding or misplacement of the catheter, but no bowel injuries occurred. One death occurred within 30 days due to pulmonary embolism. There were no significant differences in outcomes between insertion methods. Tolerance of long‐term suprapubic catheterisation was high, despite 59% of cases experiencing mostly minor complications. Tract losses during routine community change and variability in antibiotic prescribing highlighted areas for educational development which could improve patient outcomes. Conclusions This study supports the view that the risk of major complications from SPC insertion is lower than previously reported. Minor complications related to the catheter are common in the long term but are generally well tolerated.

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Section: Discussionmentioning

confidence: 99%

“…Zacharia et al. [10] described a surgical exploration for a misplaced catheter which had traversed the peritoneum but had not injured the bowel. Hall et al.…”

Section: Discussionmentioning

confidence: 99%

Suprapubic catheterisation: a study of 1000 elective procedures

et al. 2022

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“…Analysis of the rates of bowel injury prior to the NPSA alert and the publication of the original BAUS guidelines suggests a historical bowel injury risk of approximately 2.5% [4,5]. Studies published subsequent to the NPSA alert and BAUS guideline publication suggest a bowel injury rate of 0–0.2% [7–12,28]. Caution must be exercised when drawing conclusions from the comparison of these different studies, as differences in populations and methodology will introduce bias.…”

Section: Complicationsmentioning

confidence: 99%

“…Shortly afterwards, the BAUS published guidelines for safe SPC insertion [6]. Subsequent studies have reported a lower rate of bowel injury of 0–0.2% [7–12], suggesting a significant impact from the original BAUS guideline. We present an update to the BAUS guideline in light of these new data.…”

Section: Introductionmentioning

confidence: 99%

British Association of Urological Surgeons suprapubic catheter practice guidelines – revised

et al. 2020

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To report the updated and revised British Association of Urological Surgeons (BAUS) guideline on indications, safe insertion and subsequent care of suprapubic catheters (SPCs). Methods The existing BAUS guideline on the insertion of SPCs was reviewed and has been updated in light of both activity and outcome data published since the original guideline was written. A systematic review of all new data from 2010 onwards was carried out. This updated guideline is largely evidence-based but, where evidence was lacking, is based on the consensus of expert opinion from members of the BAUS Section of Female, Neurological and Urodynamic Urology. Results Suprapubic catheterization is widely used and generally considered a safe procedure. There is, however, a small risk of serious complications including bowel injury. The BAUS has produced an updated consensus statement on SPC use with the aim of minimizing risks and establishing best practice. Areas for future research and development are also highlighted. This review has been commissioned and approved by the BAUS and the Section of Female, Neurological and Urodynamic Urology. Conclusions While SPC insertion is generally regarded as a safe procedure, the risk of serious morbidity and death must always be considered and outlined to patients. These revised guidelines should assist in minimizing the morbidity associated with SPC usage.

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“…Since the NPSA reports more recent studies have reported much lower rates of BI from 0% to 0.2%, based on datasets ranging from 24 to 585 SPC insertions between 2011 to 2014. [8][9][10][11][12][13] Metanalysis of these data shows a BI rate of 1/1086, 0.09%.…”

Section: Meta-analysismentioning

confidence: 99%

A national UK audit of suprapubic catheter insertion practice and rate of bowel injury with comparison to a systematic review and meta‐analysis of available research

Hall

Ahmed

Reid

et al. 2019

Neurourology and Urodynamics

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Objectives Limited data exist on the risks of complications associated with a suprapubic catheter (SPC) insertion. Bowel injury (BI) is a well‐recognized albeit uncommon complication. Guidelines on the insertion of SPC have been developed by the British Association of Urological Surgeons, but there remains little evidence regarding the incidence of this complication. This study uses contemporary UK data to assess the incidence of SPC insertion and the rate of BI and compares to a meta‐analysis of available papers. Methods National Hospital Episodes Statistics data were searched on all SPC insertions over an 18‐month period for operating procedure codes, Code M38.2 (cystostomy and insertion of a suprapubic tube into bladder). Patients age, 30‐day readmission rates, 30‐day mortality rate, and catheter specific complication rate were collected. To estimate the BI rate, we searched patients who had undergone any laparotomy or bowel operation within 30 days of SPC insertion. Trusts were contacted directly and directed to ascertain whether there was SPC‐related BI. PubMed search to identify papers reporting on SPC related BI was performed for meta‐analysis Results 11 473 SPC insertions took place in the UK in this time period. One hundred forty‐one cases had laparotomy within 30 days. Responses from 114 of these cases reported one BI related to SPC insertion. Meta‐analysis showed an overall BI rate of 11/1490 (0.7%). Conclusions This is the largest dataset reported on SPC insertions showing a lower than previously reported rate of BI. We recommend clinicians use a risk of BI of less than 0.25% when counseling low‐risk patients.

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An audit of suprapubic catheter insertion performed by a urological nurse specialist

Cited by 3 publications

References 3 publications

Suprapubic catheterisation: a study of 1000 elective procedures

Suprapubic catheterisation: a study of 1000 elective procedures

British Association of Urological Surgeons suprapubic catheter practice guidelines – revised

A national UK audit of suprapubic catheter insertion practice and rate of bowel injury with comparison to a systematic review and meta‐analysis of available research

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