Suprapubic cystostomy for neurogenic bladder using Lowsley retractor method: a procedure revisited

Area of Science:

• Urology
• Surgical Techniques

Background:

• Neurogenic bladder (NGB) increases risks during percutaneous suprapubic catheter placement.
• The Lowsley retractor method for suprapubic cystostomy (SPC) was first described in 1988 but lacks detailed institutional experience.
• Limited data exists on the Lowsley retractor technique's application in NGB patients.

Purpose of the Study:

• To report institutional experience with the Lowsley retractor method for SPC in neurogenic bladder (NGB) patients.
• To evaluate the safety and efficacy of this technique in a specific patient population.

Main Methods:

• Retrospective study of 44 NGB patients undergoing SPC with the Lowsley retractor.
• Data collected included patient demographics, anesthesia type, operative details, and complications.
• Analysis of 49 primary catheter placements performed between 1995 and 2010.

Main Results:

• The procedure was performed under general or local anesthesia with monitored anesthesia care.
• Average operative time was 20.2 minutes; Foley catheter sizes ranged from 16F to 22F.
• Minimal blood loss, no intraoperative complications, and no incorrect catheter placements were observed. One instance of post-operative hematuria occurred.

Conclusions:

• The Lowsley retractor method for SPC is a quick and safe ambulatory procedure for NGB patients.
• This technique appears to offer a reduced risk profile compared to other methods for NGB.
• Further studies can validate these findings and establish the Lowsley retractor as a preferred method for NGB patients.