FLUOROSCOPICALLY GUIDED PERCUTANEOUS SUPRAPUBIC CYSTOSTOMY FOR LONG-TERM BLADDER DRAINAGE - AN ALTERNATIVE TO SURGICAL CYSTOSTOMY

Percutaneous large-bore suprapubic cystostomy catheters were placed un der fluoroscopic guidance in 60 patients as an alternative to surgical cystostomy. Foley catheters (16-20 F) were placed in 57 of the patien ts in a one-stage procedure. Ten-French catheters were initially place d in three patients because of difficulty in dilating percutaneous tra cks because of obesity (one patient) or dense scar tissue (two patient s). Three weeks later, 18-F Foley catheters were placed in these three patients when mature tracks had developed, making dilation easier. Mi nor complications occurred in three patients, including superficial tr ack bleeding in two and urosepsis in one. Fifteen patients were lost t o follow-up. Suprapubic catheters provided excellent long-term drainag e (range, 0.5-36 months; mean, 16 months; median, 18 months) in the re maining 45 patients. The authors conclude that percutaneous suprapubic catheter placement is a safe and effective procedure that provides ex cellent long-term bladder drainage.