Catheterization of the urinary bladder and suprapubic cystostomy

Extract

• Repeated catheterization is the preferred method Suprapubic catheters appear to be advantageous over indwelling urethral catheterisation in respect of bacteriuria, recatheterisation and discomfort in adults for short-term bladder drainage. Intermittent catheterisation appears to be associated with a lower risk of bacteriuria than indwelling one, but might be more costly.B.
• If this is not feasible (the patient has an obstruction, urinary output/hour must be monitored, catheterization cannot be performed at home in long-term care, or the patient has considerable retention > 1 000 ml) suprapubic cystostomy is preferred. It is also well suitable for long-term catheterization.
• Suprapubic cystostomy is particularly useful for checking that urine production starts to function. It is also easier for the patient than repeated catheterization.
• If the need for catheterization is temporary, the capacity of the bladder is small, or there are operative scars in the lower abdomen (risk of bowel perforation at insertion in cystostomy) a thin silicone or PVC catheter should be used.
  • If ultrasonography is available immediately before percutaneous cystostomy, the absence of bowel between the bladder and the abdominal wall can be confirmed relatively reliably.
• If the urine is bloody, a PVC catheter up to size Ch 16 can be used Urinary bladder tamponade (blood clots in the bladder)1.
• A permanent indwelling catheter should not be inserted without a medical cause in an incontinent patient in long-term care.
• Long-term catheterization is always associated with bacterial colonization. Therefore, only symptomatic infections should be treated. Infection of a suprapubic cystostomy catheter can be delayed by taking care of its base.

Read full article of Catheterization of the urinary bladder and suprapubic cystostomy

Search terms

Catheterization, Catheters, Indwelling, Cystostomy, Hematuria, PVC plastic catheter, R33, Surgery, Urethra, Urinary Bladder, Urinary Catheterization, Urinary Tract Infections, Urology, catheterization frequency, catheterization, long-time, intermittent catheterization, residual urine, silicone catheter, suprapubic cystostomy, urine sample