SUPRAPUR?: Safe and convenient percutaneous suprapubic catheterisation in high-risk patients

摘要

Introduction Ultrasound-guided percutaneous placement of a suprapubic cystostomy is a commonand generally safe procedure in everyday surgery. In case of adverse patient characteristics such as smallbladder capacity or high body mass index, however, the procedure carries an increased risk of severe complications, including bowel perforation. The Suprapur? cystostomy set is supposed to enable a safer procedure. The aim of our work was to evaluate the safety and ease of use of the Suprapur? cystostomy set.Material and methods We prospectively evaluated the Suprapur? set in high-risk patients, having either a small bladder capacity below 250 ml or a BMI above 30 kg/m2. Complications and surgical outcome were monitored. In addition, patients’ contentment and pain during the procedure was assessed witha visual analogue scale (VAS). Possible drawbacks and ease of use were evaluated by customized questionnaires for the operating physician.Results In total, 26 cystostomies were performed by 15 different physicians, 40% (n = 6) of whom were inexperienced first or second year residents. No complications occurred. Mild gross haematuria occurred in 11.5% (n = 4) of cases. Average VAS for pain during and two hours after the procedure was 2.1 (±1.2) and 0.3 (±0.5) respectively. In 91%, (n = 20) of the procedures, the physicians claimed to have felt safe using SUPRAPUR? and more comfortable (82%, n = 18) than with a conventional cystostomy set.Conclusions SUPRAPUR? allows a safe and simple placement of a suprapubic cystostomy even in high-risk patients or in inexperienced hands. It might help to reduce the complications of a common and frequent surgical procedure.