Iatrogenic direct rectal injury: An unusual complication during suprapubic cystostomy (SPC) insertion and its laparoscopic management

Abstract

Suprapubic cystostomy (SPC) is commonly used, instead of indwelling urethral catheter- ization, as indicated in many pathological conditions. Although considered to be a safe procedure that can be easily performed in an outpatient basis several complications have been reported in international literature. Bowel injury can be a serious complication with the small intestine affected in the majority of cases. We present a case of an acci- dental rectal injury by a suprapubic catheter misplacement, in a 76 year old demented patient with prostatic hyperplasia and chronic urinary retention. The injury was confirmed by cystogra- phy and injection of contrast meterial through the suprapubic catheter, and successfully treated laparoscopically by an extraperitoneal approach. The patient was discharged after 10 days with- out any complications. The above method, in experienced hands, can be an effective primary treatment option for such rare but devastating complications. The case and management is unique as, to our knowledge, as no similar cases have been presented.

Clinical evaluation of the multifunctional suprapubic catheter in patients requiring permanent suprapubic cystostomy: A prospective randomised trial in a single centre

“…Emerging evidence has shown that there are many common and different complications during suprapubic cystostomy insertion, such as rectal injury, bowel perforation (Ahmed, Mehta, & Rimington, ; Rajmohan, Aguilar‐Davidov, Tokas, Rassweiler, & Gozen, ; Witham & Martindale, ; Wu, Su, & Lin, ). However, there is still evidence reporting some rare complications during the catheter change, such as bowel injury, small bowel perforation and malpositioning in urethra (Kass‐Iliyya et al., ; Mongiu et al., ; Vaidyanathan et al., ).…”

Development and evaluation of a training model for paracentetic suprapubic cystostomy and catheterization

“…However, risk of complications may increase with incorrect performance of the technique or with poor training and education 8. The incidence of bowel perforation or other injury is reported to be as high as 2.7%, and iatrogenic direct rectal injury has also been reported 9.…”

Iatrogenic tube jejunostomy complicating suprapubic cystostomy: A case report

“…1 There have been several reports of injuries to the ileum and sigmoid colon and a few reports of injuries to the stomach and rectum. [2][3][4] Stomach injury can occur in the form of iatrogenic suprapubic gastrostomy. 4 We did not find report of jejunal injury in the literature.…”