Suprapubic catheter placement - Revision history

Blsimpso at 20:59, 29 June 2021

2021-06-29T20:59:49Z

← Older revision		Revision as of 20:59, 29 June 2021
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	==External Links==		==External Links==
			===Videos===
			{{#widget:YouTube\|id=yTFS3FILWGY}}

	==References==		==References==

Elcatracho: /* Indications */

2021-02-09T22:05:48Z

Indications

← Older revision		Revision as of 22:05, 9 February 2021
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	==Indications==		==Indications==
	*Urethral disruption due to trauma		*Urethral disruption due to trauma
	*Severe urethral stricture or complex prostatic disease		*Severe urethral stricture or complex [[Benign prostatic hyperplasia\|prostatic disease]]

	==Contraindications==		==Contraindications==

SLuckettG: /* Equipment Needed */

2019-05-13T19:42:20Z

Equipment Needed

← Older revision		Revision as of 19:42, 13 May 2019
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	*Sterile syringe		*Sterile syringe
	*Spinal needle (22 gauge for adult patients)		*Spinal needle (22 gauge for adult patients)
			*Scalpel
	*Foley cather		*Foley cather
	*Dressing		*Dressing

SLuckettG: /* Procedure */

2019-05-13T19:42:01Z

Procedure

← Older revision		Revision as of 19:42, 13 May 2019
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	==Procedure==		==Procedure==
	*Placement of the ~~Cook peel-away sheath:~~		#Use ultrasound to locate and mark the bladder
	*~~Locate~~ the ~~full~~ and ~~distended bladder with ultrasound and palpation~~		#*May use real-time ultrasound guidance to insert the suprapubic catheter, or may landmark and use a blind approach
	*Prep skin		#Prep skin
	*Fill ~~6 mL~~ syringe with 1% lidocaine and attach ~~22-gauge,~~ spinal needle		#Fill syringe with lidocaine and attach spinal needle
	*Raise skin wheal at ~~proposed~~ site ~~(2-3cm above pubic symphysis)~~		#Raise skin wheal at marked site
	*Infiltrate ~~the~~ subcutaneous tissue and rectus ~~abdominis~~ muscle fascia ~~at a 10-20 degree angle toward~~ the ~~pelvis~~		#Infiltrate subcutaneous tissue and rectus muscle fascia
	* Locate the bladder ~~by advancing the needle~~ while ~~aspirating~~ the syringe		#Advance the spinal needle into the bladder while applying negative pressure to the syringe
	* Remove the syringe ~~from the needle and advance~~ a guidewire through the needle into the bladder		#After locating the needle within the bladder, remove the syringe
	*Withdraw the ~~needle while~~ leaving ~~only~~ the guidewire		#Advance a guidewire through the needle and into the bladder
	*Use a ~~No. 15~~ scalpel ~~blade~~ to make a stab incision ~~through~~ the ~~skin~~, ~~subcutaneous tissue, and superficial anterior abdominal wall fascia~~		#Remove the syringe, leaving the guidewire
	*Pass the peel-away sheath and ~~indwelling fascial~~ dilator ~~together~~ over the ~~wire~~ into the bladder		#Use a scalpel to make a stab incision at the site of the guidewire, extending the opening for the sheath introducer
	*Remove the guidewire and fascial dilator ~~and leave~~ only the peel-away ~~sheath inside the bladder~~		#Pass the peel-away sheath and in-dwelling dilator over the guidewire and into the bladder
	*Pass the foley catheter through ~~the indwelling intravesical~~ sheath into ~~the~~ bladder		#Remove the guidewire and fascial dilator, leaving only the peel-away sheet
	*Aspirate urine to confirm ~~proper~~ placement. Inflate ~~the~~ Foley balloon ~~with of 10 mL of air, water, or saline.~~		#Insert Foley catheter through sheath and into bladder
	* Withdraw the peel-away sheath		#Aspirate urine through Foley catheter to confirm placement
			#Inflate Foley balloon
			#Remove the peel-away sheath
			#Dress the site

	==Complications==		==Complications==
	*Bowel perforation		*Bowel perforation

SLuckettG: /* Equipment Needed */

2019-05-13T19:35:49Z

Equipment Needed

← Older revision		Revision as of 19:35, 13 May 2019
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	==Equipment Needed==		==Equipment Needed==
	*Cook peel away sheath ~~unit is a user-friendly device for suprapubic bladder access~~		*Cook peel-away introducer sheath
	*If not available, ~~any device suitable for~~ central venous access ~~can be inserted suprapubically via the~~ Seldinger technique		**If not available, can use central venous access kit and use Seldinger technique to insert Foley
	*Ultrasound ~~to delineate bladder anatomy~~		*Ultrasound
	*Sterile gloves		*Sterile gloves
	*~~Skin~~ prep		*Chlorhexidine or other skin prep
	*Lidocaine		*Lidocaine
	*Sterile syringe~~, 10 or 20 mL~~		*Sterile syringe
	*Spinal needle, 22 ~~ga,~~ for adult patients		*Spinal needle (22 gauge for adult patients)
	*Foley ~~catheter~~		*Foley cather
	*Dressing		*Dressing

SLuckettG: /* Contraindications */

2019-05-13T19:33:51Z

Contraindications

← Older revision		Revision as of 19:33, 13 May 2019
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	==Contraindications==		==Contraindications==
	* Empty or unidentifiable bladder		* Empty or unidentifiable bladder
	**No ~~absolute~~ reported ~~minimum~~ bladder volume ~~has been~~ established		**Empty bladder introduces risk of through-and-through penetration of the bladder
	**But need enough urine in the bladder to allow the needle to fully penetrate the dome of the bladder without immediately exiting through the base		**No minimum reported bladder volume established
	*Should not have bowel anterior to ~~the~~ bladder		*Bowel anterior to bladder

	==Equipment Needed==		==Equipment Needed==

SLuckettG: /* Indications */

2019-05-13T19:32:40Z

Indications

← Older revision		Revision as of 19:32, 13 May 2019
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	==Indications==		==Indications==
	*~~Trauma patients with urethral~~ disruption		*Urethral disruption due to trauma
	*~~Men with severe~~ urethral stricture or complex prostatic disease		*Severe urethral stricture or complex prostatic disease

	==Contraindications==		==Contraindications==

Rossdonaldson1: /* See Also */

2018-12-08T16:52:10Z

Rossdonaldson1: /* See Also */

2018-12-08T16:33:46Z

Rossdonaldson1: Rossdonaldson1 moved page Suprapubic Catheter Placement to Suprapubic catheter placement

2018-06-26T21:02:39Z

Rossdonaldson1 moved page Suprapubic Catheter Placement to Suprapubic catheter placement

← Older revision	Revision as of 21:02, 26 June 2018
(No difference)

← Older revision		Revision as of 16:52, 8 December 2018
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	==See Also==		==See Also==
	*[[Suprapubic bladder aspiration]]		*[[Suprapubic bladder aspiration]]
			*[[Suprapubic catheter changing or replacement]]
	*[[Genitourinary trauma]]		*[[Genitourinary trauma]]
	*[[Urinary retention]]		*[[Urinary retention]]

← Older revision		Revision as of 16:33, 8 December 2018
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	==See Also==		==See Also==
			*[[Suprapubic bladder aspiration]]
	*[[Genitourinary trauma]]		*[[Genitourinary trauma]]
	*[[Urinary retention]]		*[[Urinary retention]]