Long-Term Analysis of Suprapubic Cystostomy Drainage in Patients with Neurogenic Bladder

Abstract

Objective: We assessed the roles of suprapubic cystostomy in patients with neurogenic bladder and analyzed the complications and their courses. Patients and Methods: We reviewed 118 patients with neurogenic bladder managed with suprapubic cystostomy. The original diseases were spinal cord injury in 90, degenerative disease of the central nervous system in 15, spina bifida in 6, cerebral palsy in 3, pontine bleeding in 1, Parkinson’s disease in 1, brain tumor in 1, and dysgenesis of the external sphincter in 1. Fifty-six (62.2%) of spinal cord-injured patients demonstrated cervical damage. Renal function, urinary pH and white blood cell values were measured and evaluated after insertion. The stone-free rate after insertion was estimated by the Kaplan-Meier method. Results: Indications for cystostomy were failure of clean intermittent catheterization in 62 (52.5%) and Credé’s maneuver in 2, severe urethral damage in 30 (25.4%), replacement of urethral catheter in 3, worsening of the original disease in 15 (12.7%), deterioration of the general condition in 2, mental retardation in 2, and traumatic vesical rupture in 1. Frequent complications were formation of the bladder calculi in 30 (25%) and urinary leakage through the urethra in 11 (10%). No fatal complications occurred. The stone-free rates 5 and 10 years after insertion were 77 and 64%, respectively. The urinary pH of the stone-forming group was significantly higher than that of the stone-free group. The high urinary pH group (>7.24) had a higher risk of stone formation. Conclusions: Although continuous cystostomy drainage is not considered to be ideal management for bladder emptying, some patients with neurogenic bladder may benefit from this procedure.

Quality of life and urological morbidity in tetraplegics with artificial ventilation managed with suprapubic or intermittent catheterisation

“…9 Lower urine pH status (o7.24) reduced the risk of calculus development in 118 SPC patients. 10 Our data agree with these findings.…”

Contemporary Role of Suprapubic Cystostomy in Treatment of Neuropathic Bladder Dysfunction in Spinal Cord Injured Patients

“…Further evidence by Nomura et al 18 surfaced when he looked at 118 patients with neurogenic bladders managed by an SPC. The indications for SPC in this patient population were similar to other series; failure of CIC in 53%, severe urethral damage in 35%, worsening of the original disease in 13% as well as various other individual indications.…”

Strangulated incisional hernia after suprapubic catheter insertion: A case report

“…Intermediate and longterm complications of an indwelling urinary catheter include repeated urinary tract infections, calculus formation, bladder irritation and urinary leakage. In rare cases squamous cell carcinoma has also been reported to occur [4,5].…”