Retrospective Evaluation of Contemporary Complication Rates and Severity After Suprapubic Tube Placement by Urology...

To compare complication rates and severity associated with suprapubic tube (SPT) placement by urology versus interventional radiology (IR) and to identify patient factors associated with increased complication risk.

A retrospective, single-center review from 2017 to 2022 examined patients who underwent SPT placement by urology or IR. Patients without 90-day follow-up were excluded. Patient demographics, indications for SPT placement, and perioperative, 30- and 90-day postoperative complications were recorded using the Clavien-Dindo (CD) classification system. Outcomes were compared between urology and IR. Multivariable logistic regression assessed associations between preoperative factors, specialty and major complications.

A total of 266 patients were included (179 urology, 87 IR). Median age was 68 years; 64% were male, and 56% had neurogenic bladder. Median catheter size was 18 Fr and 20 Fr for urology and IR, respectively (p = 0.05). Perioperative complication rates were low and comparable (5.6% urology vs. 5.8% IR, p = 0.80). Most 30- and 90-day complications were minor (CD grades 1-2), primarily urinary tract infections and SPT malfunction, while major complications (CD grades 3-5) were uncommon. Overall, 90-day complication rates were similar (48% urology vs. 45% IR, p = 0.66), though major complications occurred more frequently in the IR group (11% vs. 5.2%, p = 0.04). On multivariable analysis, specialty, history of pelvic radiation, and prior pelvic surgery were not significantly associated with severe complications.

Urology and IR have comparable, low complication rates for SPT placement. Perioperative complications are infrequent and more severe. Longer-term complications were common but more likely to be minor, primarily urinary tract infections or SPT dislodgement with higher rates of urinary tract infections in SPTs placed by IR.