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Fluoroscopically guided suprapubic cystostomy in complex urologic cases

D J Mond¹, W J Lee

¹Department of Radiology, Long Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, NY 11042.

Journal of Vascular and Interventional Radiology : JVIR

|November 1, 1994

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Percutaneous suprapubic cystostomy is an effective and safe procedure for complex urologic cases. Performed by interventional radiologists, this technique offers a high success rate with minimal complications.

Area of Science:

Urology
Interventional Radiology

Background:

Suprapubic cystostomy is crucial for urinary diversion.
Complex urologic cases often present challenges for traditional catheter placement.

Purpose of the Study:

To assess the efficacy and safety of percutaneous suprapubic cystostomy.
To evaluate the role of interventional radiologists in performing this procedure for challenging cases.

Main Methods:

Retrospective analysis of 25 cases requiring suprapubic cystostomy due to prior placement issues.
Procedures performed by interventional radiologists using the Seldinger technique.
Utilized 21-gauge needle for puncture, followed by tract dilation and 10-24-F catheter placement under fluoroscopic guidance.

Main Results:

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Successful suprapubic cystostomy achieved in 96% (24/25) of cases.
Ancillary urologic procedures were performed through the tract in 32% of patients.
The sole major complication was a perivesical fluid collection in 4% of patients; transient hematuria occurred in 68%.

Conclusions:

Percutaneous suprapubic cystostomy under fluoroscopic control is highly effective.
The procedure is safe, with a low rate of major complications.
Interventional radiologists are well-suited to perform this technique, particularly in complex urologic scenarios.