Prospective study of the Transurethral Suprapubic endo-Cystostomy (T-SPEC®): an ‘inside-out’ approach to suprapubic catheter insertion

Abstract

Objectives To prospectively evaluate the new medical device Transurethral Suprapubic endo-Cystostomy (T-SPeC®), used for suprapubic catheter (SPC) placement via the transurethral (inside-to-out) approach, and examine the 30-day outcomes in the first US series.MethodsIRB approval was obtained for this prospective study. We evaluated the first 114 consecutive cases of SPC placement using the T-SPeC® device by a single surgeon at in a 20-month period. We excluded patients who underwent alternative approaches to suprapubic catheter placement including open abdominal approach (12) and percutaneous approach (5). Preoperative patient demographics, operative detail, success rate and 30-day complication rate were recorded.ResultsWe successfully placed an 18 Fr suprapubic catheter using the T-SPeC® device in 98.2 % of patients. During the procedure, the capture housing was missed twice. The mean patient age was 56.6, BMI 29.4 kg/m2, skin to bladder distance 6.7 cm and operative time 3.6 min. There were 12 postoperative complications within 30 days of the procedure including urinary tract infections (6), SPC exit site infection (2), SPC blockage (2) and catheter expulsion (2). There were no Clavien–Dindo grade III–IV complications such as re-operation, small bowel injury, hemorrhage or death.ConclusionThe T-SPeC® device is a novel, simple, accurate and minimally invasive device for SPC insertion from an inside-to-out approach. Our prospective study demonstrates that the T-SPeC® device can be placed safely and efficiently in a variety of patients with a need for urinary drainage.

Using central venous catheter for suprapubic catheterization in cardiac surgery

“…The device has mainly been used in female patients with acceptable safety. However, in comparison with our method the method is more invasive, needs more urological skills, and may be more risky when done by anesthesiologists 8. There are different insertion kits for different clinical situations.…”

Minimal Invasive Cystometry and Intra-Abdominal Pressure Assessments in Rodents: A Novel Animal Study

“…The traditional method or the latest modified method [ 23 ] for urodynamic test of rodents are underwent suprapubic cystostomy, which were approximately equal to relieve the obstruction in varying degrees, and it may destroy the natural history and pathophysiology of BOO. At the same time, it also increase the exposure risk to infectious pathogens after the suprapubic cystostomy [ 24 ]. In the next step, we are going to study the cellular signaling pathways, for example, the expression of PI3K (phosphoinositide 3-kinase) and SGK1 (serum-glucocorticoid regulated kinase 1), which we found in vitro previously [ 25 ], to test and verify it in BOO model.…”

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

“…An appropriate training model should have the following qualities: it must mimic the real clinical environment and simulate the entire surgical procedure; it should provide accurate sensory feedback (i.e., felt by the surgeon's hands); multiple copies of the model must be available for rapid cycling through simulations to ensure that all trainees are able to practice the technique; components of the model should be inexpensive and easy to replace, with a low overall cost for the entire model; and, most importantly, the model should be conducive to improving trainee understanding of the procedures and increasing their confidence in performing the operation 5,6. Among many studies introducing training models for suprapubic cystostomy 5-7,10-12, the above guidelines were applied in two studies introducing cost-effective simulation training models 5,6. Shergill et al 5 developed and introduced a safe, simple model of suprapubic catheter insertion to junior doctors in a urology emergency training program, thus improving their ability to perform the procedure in clinical practice with repetitive use.…”