Suprapubic Cystostomy for Neurogenic Bladder Using Lowsley Retractor Method: A Procedure Revisited

Edokpolo, Leonard U.; Foster, Harris E.

doi:10.1016/j.urology.2011.07.1393

Cited by 11 publications

(12 citation statements)

References 11 publications

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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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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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“…Suprapubic cystostomy is commonly used for long-term as well as temporary urinary drainage. Patients requiring long-term urinary drainage would include those with a neurogenic or end-stage bladder who are unable or unwilling to perform clean intermittent catheterization [ 3 ]. Patients needing long-term bladder drainage prefer chronic SPC to a Foley as it avoids the risk of urethral erosion [ 4 ].…”

Section: Commentsmentioning

confidence: 99%

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

et al. 2014

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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.

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“…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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Suprapubic Cystostomy for Neurogenic Bladder Using Lowsley Retractor Method: A Procedure Revisited

Cited by 11 publications

References 11 publications

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

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

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

British Association of Urological Surgeons suprapubic catheter practice guidelines – revised

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