51102 Aspiration of bladder; with insertion of suprapubic catheter

Name of the Procedure:

Aspiration of bladder; with insertion of suprapubic catheter (SPC)

• Common names: Suprapubic catheter placement

Summary

Aspiration of the bladder with the insertion of a suprapubic catheter is a procedure where a tube is placed through the lower abdomen into the bladder to drain urine. This method is often used when conventional urination or urethral catheterization is not suitable.

Purpose

The procedure addresses urinary retention or blockage. It helps ensure a continuous way for urine to be expelled from the bladder, preventing discomfort and potential kidney damage.

Indications

• Chronic urinary retention
• Bladder outlet obstruction
• Neurogenic bladder
• Patients requiring long-term drainage
• Trauma or other conditions making urethral catheterization impossible

Preparation

• Fasting for a few hours prior to the procedure may be required.
• Medication adjustments, especially blood thinners, may be necessary.
• Pre-procedure imaging (ultrasound) to check bladder fullness and position.

Procedure Description

1. The patient lies on their back, typically after receiving local anesthesia to numb the lower abdomen.
2. An appropriate site on the abdomen is chosen and sterilized.
3. A small incision is made just above the pubic bone.
4. A needle is inserted to aspirate urine and confirm the bladder's position.
5. A guidewire and dilators are used to create a tract into the bladder.
6. The suprapubic catheter is inserted and secured.
7. The catheter is connected to a drainage bag, which collects urine.

Tools: Sterile gloves, antiseptic solution, needle, guidewire, dilators, suprapubic catheter, drainage bag.

Duration

The procedure typically takes about 30 minutes.

Setting

Usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Urologist or trained medical doctor
• Nurses or surgical assistants
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Infection at the insertion site
• Hematuria (blood in urine)
• Accidental injury to adjacent organs
• Catheter blockage or displacement
• Pain at the insertion site

Benefits

• Immediate relief from urinary retention
• Reduced risk of kidney damage
• Improved quality of life for individuals requiring long-term catheterization

Recovery

• Monitoring for signs of infection or complications.
• Instructions on catheter care and maintenance.
• Pain management strategies.
• Urine output will be monitored to ensure the catheter is functioning properly.
• Follow-up appointments for catheter changes or assessments of bladder function.

Alternatives

• Urethral catheterization
• Intermittent self-catheterization
• Medications to address underlying causes of urinary retention
• Surgical interventions in certain cases

Patient Experience

During the procedure, slight discomfort or pressure may be felt, particularly when the needle or catheter is inserted. Post-procedure, patients may experience localized pain, managed by over-the-counter pain medication or prescribed analgesics. Initial unfamiliarity with catheter maintenance might require some adaptation and education.

Note: This is a general guide; the exact procedure and protocols may vary based on individual patient needs and institutional practices. Always consult with a healthcare provider for personalized advice.