Continence (Sep 2022)
Understanding suprapubic catheter usage in the Canterbury population
Abstract
Background:: Suprapubic catheter (SPC) insertion is a common urological procedure, typically performed for individuals who are unable to drain their bladder via the urethra. While often considered to be safe and straightforward, our experience suggests this procedure may be associated with significant comorbidity, serious adverse events, and a higher length of stay than expected. This study aimed to understand current rates of SPC insertion, demographics, indications, complications, and length of stay. Methods:: A retrospective review of all patients having undergone SPC insertion at Christchurch Hospital since the inception of the SPC synoptic note in 2017 was undertaken. Data was collected on demographics, indication, procedural details, in-hospital complications, length of stay and long-term outcomes. Patient groups were identified to determine if there were any predictive factors placing individuals at an increased risk of complications. Results:: Data was analysed on 213 SPC insertions performed using the Add-a-Cath trocar technique (29.4% female); the mean age at insertion was 64.2 (range: 8–98). Overall, there were 2 intraoperative bowel perforations, in these patients neither had a previous abdominal incision or difficult to distend bladders and in both cases the bladder was filled with their existing urethral catheter. 47.7% of SPC insertions were associated with at least 1 complication following discharge requiring reattendance to hospital. The mean length of stay for those who presented to the hospital was 3.1 days. Infective factors were the most common complications, accounting for 43.3% of presentations. Long term complications were similar in patients whose bladder was filled via cystoscope (50.4%) versus urethral catheter (44.7%). Eight patients (3.79%) required surgical reinsertion of their SPC.Seven patients underwent open cut-down SPC insertion (42.9% female); of these, there was one intraoperative bowel perforation and 57.1% experienced at least one complication following discharge. The average number of visits relating to SPC complications following discharge was 8. Conclusion:: While SPC insertions are commonly perceived to be well tolerated by patients and a simple solution to catheter-related issues, our study highlights a higher than previously understood rate of complications following discharge. This data will facilitate informed decision making between clinician and patient, recognising potential risk factors that increase an individual’s likelihood of experiencing adverse events leading to improved resource allocation.
