When a person is unable to urinate voluntarily, they may require the intervention of a catheter to prevent further complications such as infections and kidney damage.
There are different types of urinary catheters, which you can learn about on our page dedicated to the different types of catheters. This article will look specifically at suprapubic catheters and their advantages over indwelling Foley catheters.
A suprapubic catheter is the only type of catheter that enters the bladder via the abdominal wall.
This type of catheter can be used in an emergency setting or for longer-term indications, such as in patients with spinal cord injuries or neurological disorders. 25% of suprapubic catheterisations are performed in an emergency setting[1].
In certain instances, suprapubic catheterisation may not be possible. These instances include, but are not limited to:
There are many reasons why suprapubic catheters might be preferable over other types of catheters.
The satisfaction rate for suprapubic catheters is high among patients. A 2017 study analysed 70 women receiving suprapubic catheters. In the suprapubic group, 82% reported a better quality of life, and 89% of the patients who had previously had a urethral catheter reported to prefer the suprapubic catheter[2].
Suprapubic catheterisation can provide a more comfortable experience as bladder spasms are reduced due to the lack of catheter irritation to the overflow area of the bladder.
Suprapubic catheters are easier to keep clean, and they don't come into contact with the genitals. This means there is less bacteria transference when compared to urethral catheters, reducing the risk of Catheter-Associated Urinary Tract Infections (CAUTIs).
In a study that looked at catheterisation after radical hysterectomy, it was found that the urethral catheterisation group had a higher proportion of patients with UTIs at 27%. In comparison, just 6% of the suprapubic catheter group suffered from UTIs (P < 0.001)[3].
On average, CAUTIs keep patients in the hospital for 0.5–5 extra days, resulting in increased hospital costs[4].
As with most clinical procedures, there is a risk involved with suprapubic catheterisation. However, these risks are mainly associated with the insertion technique.
When inserted blindly without the aid of a guidewire, there is a risk of bowel perforation. Standard suprapubic catheterisation has a 10% complication rate, with a 2.7% rate of bowel injury[5]. It is also reported that clinicians feel nervous when doing this procedure blind due to the risk of injury[6].
Seldinger technique, the Mediplus S-Cath™ System provides clinicians with an alternative method of suprapubic catheterisation with increased safety.
A study found that clinicians were more comfortable performing suprapubic catheterisation with S-Cath™ System[7].
Suprapubic catheterisation can be performed in an outpatient setting when using the Mediplus S-Cath™ System, allowing more patients to be seen and potentially reducing NHS waiting lists.
By moving suprapubic catheterisation into an outpatient setting, the amount of time patients spend in the hospital is significantly shortened. A study reported that the Mediplus S-Cath™ System could reduce hospital time for suprapubic catheter insertion from 2.3 days to 28 minutes in an outpatient setting[8].
Conventional suprapubic catheter insertion often requires general anaesthesia and operating theatre time. The Mediplus S-Cath™ System allows suprapubic catheterisation to move into an outpatient setting, reducing the need for general anaesthesia and operating theatre time.
One study found that 90% of non-Seldinger patients required general anaesthesia, compared with only 3% who underwent the Seldinger technique[9]. This creates cost savings; the Bristol Urological Institute evaluated the savings and calculated that approximately £100,000 per year can be saved per hospital[10].
The Mediplus S-Cath™ System allows healthcare professionals, including nurse practitioners, to perform suprapubic catheterisation using the Seldinger technique.
An update to the British Association of Urological Surgeons (BAUS) guidance in 2020 stated that clinicians must consider individual risk factors for bowel injury when planning suprapubic catheter insertion and mitigate the risk where possible.
The Mediplus S-Cath™ System allows clinicians greater accuracy and control when inserting the catheter to mitigate the risks posed by the procedure.
For more information about S-Cath™ System, visit our product page.
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