Suprapubic bladder drainage in colorectal surgery

Seventy-six consecutive patients were studied prospectively in order to assess the value of suprapubic bladder drainage following surgery of the rectum and sigmoid colon. An Argyle-Ingram catheter (ICI) was inserted after the laparotomy incision had been made and the bladder was drained continuously for 24 h after which the catheter was closed and opened only every 6 h for 10 min. The patients were invited to void at will after the first 24 h. The catheter was removed when the post-voided volume became less than 50 ml on each of two subsequent measurements. The longest period of drainage was necessary after rectal excision, while rectosigmoid resections demanded shorter periods. The catheter did not function in one patient and urethral catheterization became necessary after removal of the suprapubic catheter in 4 patients. The method of suprapubic bladder drainage is recommended because it permits spontaneous voiding, allows measurement of residual volume without urethral instrumentation, gives little discomfort to the patient and has few complications.