Percutaneous Bladder Catheterization (Suprapubic Bladder Catheterization)

摘要

Suprapubic catheter (SPC) insertion is a urologic procedure performed for several reasons. In the event of bladder outlet obstruction caused by a urethral stricture or an enlarged prostate, it is a quick way to drain the bladder at the bedside thereby resolving patient discomfort from an overly distended bladder. At other times, an SPC is placed permanently as in the case of neurogenic bladder where the patient is unable to void and is at risk for urinary tract infections (UTIs) and upper urinary tract deterioration from a chronically distended bladder. There are several methods by which the clinician may place an SPC depending on the indication. The options range from an open suprapubic cystostomy, transurethral using modified sounds, percutaneous using trocars, and the Seldinger technique. Each of these methods has various technical modifications. This article focuses on percutaneous SPC placement. Anatomy The bladder is an ovoid-shaped muscular structure that is hollow and stretches quite easily because of its compliance properties. The maximum capacity of an adult bladder is about 500 ml_, but it is not unusual for the patient in acute retention to have in excess of 1 L in the bladder. The bladder is anchored to the anterior abdominal wall by a fibrous chord called the urachus. The posterior surface of the bladder is lined with the parietal peritoneum.