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Suprapubic bladder drainage in elective colorectal surgery.

K E Klaaborg, O Kronborg

    Diseases of the Colon and Rectum
    |April 1, 1986
    PubMed
    Summary
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    Suprapubic bladder drainage is a safe and effective method for patients undergoing colorectal surgery, minimizing the need for urethral catheterization and allowing spontaneous voiding. Complications are rare, with patient discomfort reported in only 1%.

    Area of Science:

    • Urology
    • Surgical Procedures
    • Postoperative Care

    Background:

    • Colorectal surgery, particularly abdominoperineal excision, often necessitates bladder drainage.
    • Traditional urethral catheterization can lead to complications and discomfort.
    • Alternative drainage methods are sought to improve patient outcomes.

    Purpose of the Study:

    • To evaluate the efficacy and safety of suprapubic bladder drainage in patients undergoing rectal and sigmoid colon surgery.
    • To assess the duration of drainage and identify factors influencing it.
    • To compare suprapubic drainage with urethral catheterization in this patient population.

    Main Methods:

    • A prospective study involving 399 patients undergoing colorectal surgery.
    • Insertion of a 16 French Argyle-Ingram suprapubic catheter post-laparotomy.

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  • Continuous drainage for 24 hours, followed by intermittent clamping and voiding trials.
  • Catheter removal criteria based on post-void residual volume (<50 ml).

    • Main Results:

    • Suprapubic drainage was successful in most patients, with abdominoperineal excision requiring the longest drainage period.
    • Urethral catheterization was necessary in 19 patients (4.8%) due to urinary retention.
    • Catheter failure occurred in 17 of 31 patients, necessitating urethral catheterization.
    • One case of uroperitoneum was reported and successfully managed with relaparotomy.

    Conclusions:

    • Suprapubic bladder drainage is recommended following colorectal surgery as it facilitates spontaneous voiding and reduces the need for urethral instrumentation.
    • It allows for accurate measurement of residual urine volume without urethral catheterization.
    • The procedure is associated with a low complication rate (1% discomfort) and high success rate.