Consent: Suprapubic Catheterisation - Podcast Version 0:00 / 0:00 1x 0.25x 0.5x 0.75x 1x 1.25x 1.5x 1.75x 2x This article is for educational purposes only. It should not be used as a template for consenting patients. The person obtaining consent should have clear knowledge of the procedure and the potential risks and complications. Always refer to your local or national guidelines, and the applicable and appropriate law in your jurisdiction governing patient consent. Overview of Procedure Suprapubic catheterisation involves the insertion of a catheter through the abdominal wall, directly into the bladder. It can be performed under local anaesthesia, using ultrasound guidance and a Seldinger technique This is most commonly performed for urinary retention in patients who have contraindications to urethral catheterisation, such as urethral trauma, strictures, or prostatic enlargement. Suprapubic catheterisation may also be used for management of long term neurological conditions where other treatment methods have failed. Complications Intraoperative Complication Description of Complication Potential Ways to Reduce Risk Haemorrhage Damage to blood vessels or intraluminal damage to the bladder Damage to surrounding structures Damage or perforation of the bladder or bowel Perform procedure under ultrasound guidance Anaesthetic risk Local anaesthetic toxicity or reaction Early Complication Description of Complication Potential Ways to Reduce Risk Pain Instrumentation can result in bladder spasms, resulting in suprapubic pain Infection Infection can be introduced by the instrumentation, however the overall risk is very low Maintain an aseptic technique throughout the procedure Late Complication Description of Complication Potential Ways to Reduce Risk Recurrent UTIs Can occur from bacterial colonisation of the long-term catheter Aseptic technique during insertion, regular catheter changes Catheter blockage Caused by encrustation and bacterial colonisation of the catheter lumen Regular catheter changes and consider increasing the catheter lumen Bladder stone formation The long-term catheter can act as a nidus for infection and subsequent stone formation Regular catheter changes and ensure fluid intake to promote good urine output Frequent questions What is suprapubic catheterisation? Suprapubic catheterisation is a medical procedure that involves inserting a catheter through the abdominal wall directly into the bladder. It is typically performed under local anaesthesia and is often guided by ultrasound. What are the main indications for performing suprapubic catheterisation? This procedure is primarily indicated for urinary retention in patients who cannot undergo urethral catheterisation due to conditions like urethral trauma, strictures, or prostatic enlargement. It may also be beneficial for patients with long-term neurological conditions when other treatments have failed. What complications can occur during suprapubic catheterisation? Intraoperative complications can include haemorrhage from damaged blood vessels and damage to surrounding structures such as the bladder or bowel. Performing the procedure under ultrasound guidance can help mitigate these risks. What are the early complications associated with suprapubic catheterisation? Early complications may include pain from bladder spasms and the risk of infection due to instrumentation. Maintaining an aseptic technique during the procedure is crucial to reduce the likelihood of these complications. How can late complications from suprapubic catheterisation be prevented? Late complications, such as recurrent urinary tract infections (UTIs) and catheter blockage, can be minimised through regular catheter changes and ensuring an adequate fluid intake. This helps promote good urine output and reduces bacterial colonisation. Rate This Article