Suprapubic Bladder Drainage in General Surgery

Pilot study of cholecystectomy patients showed 6% developed urinary tract infections. Perioperative urethral catheterization was required in 30%, of which 20% developed symptomatic urinary tract infection. This high postoperative morbidity related solely to the genitourinary tract prompted us to investigate an alternative procedure. During intra-abdominal procedures, 300 patients had routine, intra-operative, percutaneous, suprapubic insertions of Supracath (group A) or suprapubic Foley (group B) catheter. In group A, 3.7% mechanical complications and 8.2% bacteriuria were noted. Bacteriuria dropped to 2.7% if catheters functioned until removal. In group B there were no mechanical complications and 35% incidence of bacteriuria (100% for urethral catheters inserted an equal length of time).

Suprapubic catheterization affords much lower incidence of bacteriuria than urethral catheterization and, more importantly, absence of symptomatic urinary tract infection. This technique additionally offers advantages of simplicity and complete patient comfort and acceptance.