Suprapubic catheterisation: a study of 1000 elective procedures.

Area of Science:

• Urology
• Neurosurgery
• Medical Devices

Background:

• Suprapubic catheter (SPC) insertion is a common procedure for urinary management.
• Patients with spinal cord injury (SCI) often require long-term catheterization, necessitating evaluation of SPC risks and outcomes in this population.

Purpose of the Study:

• To investigate the risks and long-term outcomes associated with suprapubic catheter (SPC) insertion.
• To assess the safety and tolerability of SPCs in a cohort predominantly comprising individuals with spinal cord injuries.

Main Methods:

• Retrospective analysis of 1000 consecutive SPC insertions from 1998 to 2015 at the National Spinal Injuries Centre.
• Utilized theatre database records for patient data, with follow-up ranging from 4 weeks to 16.45 years (median 3.3 years).
• Procedures included cystoscopy-guided suprapubic puncture or direct incision with cystoscopy.

Main Results:

• Major complications (Clavien-Dindo IIIb or higher) occurred in 0.6% of patients; 0.4% required return to theatre.
• No bowel injuries were reported; one death within 30 days was attributed to pulmonary embolism.
• Long-term tolerance of SPCs was high, with 59% experiencing minor complications, often related to tract issues or antibiotic prescribing.

Conclusions:

• SPC insertion demonstrates a lower risk of major complications than previously suggested.
• While minor complications are frequent in long-term SPC use, they are generally well-tolerated by patients.
• Educational development in catheter care and antibiotic stewardship could further enhance patient outcomes.