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Suprapubic Cystostomy

Surgical creation of a percutaneous urinary drainage tube directly into the bladder above the pubis.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is Suprapubic Cystostomy?

Suprapubic cystostomy (SPC) is the placement of a urinary drainage catheter into the bladder via a percutaneous or open approach through the lower anterior abdominal wall, approximately 2 cm above the pubic symphysis. It provides bladder drainage when urethral access is contraindicated by stricture, trauma, severe urethritis, complex pelvic surgery or chronic neurogenic bladder dysfunction.

Indications include acute and chronic urinary retention with failed urethral catheterization, urethral or bladder neck reconstruction, post-prostatectomy urinary leakage, severe urethral trauma and complex genitourinary fistulas. Long-term SPC is preferred over chronic urethral catheter in many neurogenic patients due to lower urethral erosion and stone formation risks.

The procedure is performed percutaneously under ultrasound or cystoscopic guidance with the bladder distended (>300 mL), or open under local/regional anesthesia. Complications include bowel perforation (rare with full bladder), bladder wall injury, hematuria, infection, catheter blockage, encrustation and stomal granulation. Catheter changes are typically every 4-12 weeks depending on the device.

Symptoms

Urinary retention requiring drainage
Bladder distension and suprapubic pain
Failure of urethral catheterization
Urethral trauma or stricture
Post-surgical urinary leakage
Neurogenic bladder with complications
Chronic indwelling catheter complications

Risk Factors

Urethral stricture disease
Pelvic trauma and urethral injury
Spinal cord injury and neurogenic bladder
Post-prostatectomy or radical pelvic surgery
Severe BPH with refractory retention
Complex urethral reconstruction
Recurrent urinary tract infections from urethral catheter

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Tube blockage with no urine output
  • Hematuria with clots
  • Severe suprapubic pain or fever
  • Catheter dislodgement
  • Persistent leakage around stoma

Treatment Methods

01
Bladder distension confirmation (US, palpation, instillation)
02
Percutaneous trocar/Seldinger technique under US guidance
03
Open suprapubic cystostomy under direct vision
04
Initial Foley or specific suprapubic catheter (12-16 Fr)
05
Routine bladder irrigation as needed
06
Tube change every 4-12 weeks
07
Antibiotic prophylaxis at exchanges (selected cases)
08
Stomal site care to prevent skin maceration
09
Monitoring for blockage, hematuria, infection
10
Definitive urethral repair when feasible

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.