Comparative study of perioperative morbidities of the conventional and ultrasound-guided suprapubic catheterization in the patients of urinary retention during emergency

Abstract

Background: Urinary retention is one of the common urological emergencies and conventional ‘blind’ SPC frequently used comfortable as well superior procedure for patients. During conventional SPC, the distended bladder is identified by palpation or percussion without proper attention to intervening bowel segment and other structures. However, the recently published data suggests that if, ultrasound is used during SPC, and it identifies not only bladder but also intervening bowel segment which complications. Therefore, the objective of this study was to assess and compare the perioperative complications of both methods.Methods: This prospective study was conducted between years November’2017 to June’2019. Sixty patients (n=60) of urinary retention were randomized to undergo ultrasound guided or conventional SPC procedures. Patients were divided into two equal groups of 30 patients in US-SPC (Group-A) and C-SPC (Group-B). After either SPC, the patients were closely observed for development of complications.Results: Overall, the patients had mean age of 53.87+21.418 and 53.87+21.418 years in C-SPC and US-SPC group, respectively. Mean operative time and subsequent initial urine drainage were almost equal in both groups. However, in C-SPC group, 5(16.7%) patients developed complications in the form of 03 misplaced catheters outside bladder, 01 into retro pubic space and another 01 into rectum. All patients in Group-A required ultrasound guided revision of SPC compared to none in Group-B.Conclusion: Overall, the ultrasound-guided SPC (US-SPC) is safer procedure compared to conventional ‘blind’ C-SPC in relieving urinary retention in emergency, thus it should be recommended procedure whenever need arise for SPC procedure.

Reliability of percutaneous suprapubic cystostomy catheter insertion and analysis of complications

“…In another study, it was reported that the USG-assisted technique was simple, safe, effective and associated with minimal complications [8]. In two studies comparing direct blind and USG-assisted techniques in the literature, the ultrasonography procedure was found to be safer, which is consistent with our study [5,6]. In our study, no difference was found between the two techniques in the groups except for early complications.…”

“…Causes of urinary retention include benign prostatic hyperplasia (BPH), urethral stricture, prostate cancer, clot retention, stone and neurological bladder [7]. In two studies reported in the literature, urethral stricture and BPH were determined as the most common causes of urinary retention in patients with PSCC, respectively, and there was only one female patient in both study populations [5,8]. Similarly, the most common etiological factor in our series was urethral stricture, and the second was BPH.…”

“…It was observed that the majority of the cases included patients with neurogenic bladder [11]. In the series of Chandra et al, catheter malposition was seen in 5 (16.7%) of 30 patients with conventional PSCC insertion, and it was not observed in any patients with USG-assisted PSCC insertion [5]. In our series, catheter revision was performed in two patients due to the lack of effective urinary drainage.…”

“…Early and late complications have been reported [4]. In the literature, there are a limited number of studies comparing conventional and USG-assisted technique, and which of these two techniques is superior has not been clearly demonstrated [5,6]. The primary objective of this study was to determine the reliability of the procedure and evaluate immediate and early complications in patients with PSCC insertion with two different techniques.…”