3. Contents
LOGO
1 II Introduction
2I Indications and Contraindications
3 Equipments
4 Patient Preparation and Techniques
5 Complications
www.themegallery.com
4. Introduction
LOGO
Complaint of lower genitourinary symptoms is
most common Urologic Problems
Urine play role for diagnosis and management
Transurethral is preferred method
When the transurethral route is
contraindicated
A Percutaneous approach becomes the solution
www.themegallery.com
5. Introduction
LOGO
Suprapubic bladder catheterization has
become the treatment of choice for the patient
with acute urinary retention
Commonly performed in the trauma patient
with a known or suspected urethral injury
Use local anesthesia
It is a relatively safe procedure but does have
potential complications that are significant.
www.themegallery.com
7. Contraindications
LOGO
Patients with a coagulopathy
Prior lower abdominal surgery
Relative Contraindications
History of pelvic cancer or pelvic radiation therapy,
ascites, urinary tract infections, or who are
uncooperative
www.themegallery.com
8. Equipments
LOGO
Percutaneous cystostomy catheter kit
Foley catheter, 14 to 16 French
60 mL catheter-tipped syringe
10 mL syringes
24 to 25 gauge spinal needle, 3 inches long
No.11 Surgical scalpel blade on a handle
3.0 nylon suture
Needle driver
Povidone iodine solution
www.themegallery.com
9. Equipments
LOGO
Local anesthetic solution, 1% lidocaine
4x4 gauze squares
25 gauge needle, 1 inch long
18 gauge needle
Urine meter or urine leg bag
Sterile towels
Sterile gloves
Sterile drapes
Tincture of benzoin
2 inch tape
Ultrasound machine (optional)
www.themegallery.com
12. Patient Preparation
LOGO
Risk and benefit discussion
Obtain an informed consent
Place the patient supine
Apply povidone iodine solution to the lower
abdomen
www.themegallery.com
19. Aftercare
LOGO
Secure the catheter to the abdominal wall
Place 4x4 gauze squares over the pubic
symphysis
Apply tincture of benzoin to the abdominal
wall and allow it to dry
Tape over the catheter and gauze
www.themegallery.com
20. Aftercare
LOGO
Examine the puncture site twice a day for any
signs of infection
If removed within 7 days, heal without
complications
After 10 to 14 days, the tract is epithelialized
and mature
The catheter may be exchanged through the
mature tract
www.themegallery.com