Part of the TeachMe Series

Consent: Suprapubic Catheterisation

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Last updated: June 18, 2021
Revisions: 8

Last updated: June 18, 2021
Revisions: 8

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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
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