Suprapubic Cystostomy
(Cystostomy, Suprapubic)
Definition
Suprapubic cystostomy is a procedure to help drain the bladder (organ that collects and holds urine). A tube called a catheter, which leads out of the lower abdomen, is inserted to drain the bladder.
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Reasons for Procedure
This procedure may be done if:
- You cannot urinate
- A catheter cannot be passed through the urethra to help you urinate
- You have complications from a catheter in the urethra
- To make maintenance and changing the catheter easier
Urine may not be able to pass through the urethra due to:
- Narrowing of the urethra
-
Other blockage, caused by:
- Stones
- Inflammation
- Infection
- Injury
- Prostate disease (in men)
The procedure may also be done if you need to:
- Avoid damaging the urethra
- Have surgery on the urethra or nearby structures
- Have a catheter in your body long-term
Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Damage to the bowel or other surrounding structures
- Need for a repeat procedure
- Infection
- Bleeding
- Blood clots
- Anesthesia reaction
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
Your risk of complications may also increase if you have:
- Bleeding disorders
- Taken medications that reduce blood clotting
- Had previous abdominal surgery
- Bladder cancer
What to Expect
Prior to Procedure
Your doctor may do the following:
- Physical exam
- Imaging, blood, and urine tests
- Talk about the anesthesia being used and the potential risks
Talk to your doctor about any medications, herbs, or supplements you are taking. You may be asked to stop taking some medications up to 1 week before the procedure.
In the days before the surgery:
- Arrange for a ride home from the hospital.
- You may need to avoid eating for 8 hours before the surgery.
- If instructed by your doctor, drink only clear liquids, such as water, clear juices, tea. You may be asked to drink extra fluids to fill the bladder.
Note —These steps may not be possible in an emergency situation.
Anesthesia
Local anesthesia may be used with or without sedation. You will not have any pain during the procedure.
Description of the Procedure
After anesthesia has numbed the area, the doctor will locate the bladder using imaging tools such as ultrasound if needed. Next, a needle will be inserted through your lower abdomen and into your bladder. A wire or sheath will then be guided into the bladder to prepare the site for a catheter. A special catheter will be placed into the bladder. The catheter will be sutured in place. A balloon may be inflated to keep the catheter in place. Afterward, the opening made in the skin (called a stoma) will be covered with gauze.
How Long Will It Take?
10-45 minutes
How Much Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Average Hospital Stay
You will either stay in the hospital overnight or go home the same day.
Post-procedure Care
At the Hospital
The hospital staff will:
- Monitor your recovery
- Help you to eat and move around again
- Give you pain medication
- Teach you how to care for your catheter
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to reduce your chances of infection such as:
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incisions
At Home
You will have to restrict your activities while you recover. Follow instructions on cleaning the stoma. It will help prevent infection. The hospital staff will teach you how to change the catheter and collection bag.
Call Your Doctor
Call your doctor if any of these occur:
- Pain or cramps
- Redness or soreness around the catheter site
- Catheter fails to drain
- Catheter falls outs
- Changes in frequency, odor, appearance, or volume of urine
- Signs of infection, including fever or chills
- Bloody urine
If you think you have an emergency, call for emergency medical services right away.
RESOURCES:
National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov
Urology Care Foundation
http://urologyhealth.org
CANADIAN RESOURCES:
Canadian Urological Association
http://www.cua.org
Health Canada
https://www.canada.ca
REFERENCES:
Aguilera PA, Choi T, Durham BA. Ultrasound-guided suprapubic cystostomy catheter placement in the emergency department. J Emerg Med. 2004;26(3):319-321.
Jacob P, Rai BP, Todd AW. Suprapubic catheter insertion using an ultrasound-guided technique and literature review. BJU Int. 2012;110(6):779-784.
Last reviewed March 2020 by EBSCO Medical Review Board Adrienne Carmack, MD Last Updated: 1/29/2021