Suprapubic Cystostomy

Suprapubic Cystostomy (SPC) refers to a medical intervention where a catheter (tube) is cut into the bladder via the lower abdomen over the pubic bone to remove urine. It is commonly done in cases where the normal urinary cannot be administered because of an obstruction of the urethra or other issues of the urinary line.

Procedure

• General or local anaesthesia is done.
• The skin in and above the pubic region is scrubbed and cut.
• A catheter is inserted by passing through the wall of the abdomen into the bladder.
• The catheter is fastened so that the urine can be drained into a collection bag continuously.

Suprapubic Cystostomy Benefits

The following are the key advantages of Suprapubic Cystostomy (SPC):

Prevents Urethral complications

Compared to urethral catheters, SPC does not traverse the urethra and thus minimizes the threat of:

• Trauma or strictures of urethra.
• Urethral infections
• Side effects with prolonged use.

More Desirable as Long-term Drainage

Perfect in patients requiring chronic bladder drainage which include:

• Neurogenic bladder
• Prostate enlargement
• Evaluative urinary issues.

Reduced Risk of Infection

• Compared to the long-term urethral catheters, suprapubic catheters have lower chances of developing urinary tract infections.

Comfort and Mobility

• Lower level of discomfort than urethral catheters.
• Less difficult in its daily functions and sexual activity since the urethra is free.

Applicable in Special Situations

• Following pelvic surgery or urethral surgery in which urethral catheterization is no longer possible.
• In case of urethral trauma or strictures, SPC is a safe way of getting the urine out.

Aids in Bladder Control

• Gives the bladder time to rest and recuperate following surgery, injury or obstruction.
• Bladder irrigation can be done as required.

Factors Affecting Suprapubic Cystostomy Surgery Cost

Suprapubic Cystostomy (SPC) may cost a great deal in India depending on a number of factors. The following list will give a rough estimate of the main factors that affect the total cost:

Hospital Type and Location

• Private Hospitals: These are generally high-end and have more amenities and facilities which make them expensive.
• Urban vs. Rural: Urban areas with a large population such as Delhi, Mumbai, and Hyderabad would be more expensive than smaller towns. 

Surgeon's Expertise

• Urologists who are highly experienced or specialized can be costly.

Procedure Complexity

• Extra costs can be incurred by emergency procedures or ones involving complex methods.

Postoperative Care

• Long hospital stay, rehabilitation and follow-ups also add to the total cost.

Quality of the Catheter and Equipment

• The cost can be increased through the use of high-end catheter sets and other medical devices.

Best Hospitals for Suprapubic Cystostomy

• Artemis Hospital, Gurgaon
• Medanta-The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket

Suprapubic Cystostomy Indications

Suprapubic Cystostomy (SPC) Indications refer to the health conditions when this surgery is prescribed. It is normally employed when patients are not able or not recommended to urinate normally.

Urinary Retention

In the case of the inability of the bladder to empty as a result of:

• Benign prostatic hyperplasia (BPH)
• The urethral strictures (narrowing of the urethra).
• Stone and tumor-induced urethral obstruction.

Neurogenic Bladder

• Patients unable to control urination with nerve-related bladder dysfunction (e.g., spinal cord injury, multiple sclerosis).

Urethral Injury or Surgery

• After urethral trauma, surgery or a situation that does not allow or is not safe to catheterise through the urethra.

Long-term Catheterization Requirements

• Patients who need chronic bladder drainage in which the catheter of the urethra is less comfortable and more likely to cause infections.

Pelvic Trauma or Surgery

• In case of a surgery on the pelvis, bladder, or urethra, SPC may assist in the drainage of the bladder in the recovery period.

Unsuccessful/Problematic Urethral Catheterization

• In case of failure to insert a urethral catheter, SPC allows an alternative entry.

Bladder Irrigation or Management

• Applied in scenarios where a bladder has to be irrigated or there is a need to constantly check the amount of urine discharged in a critical patient.

Suprapubic Cystostomy Complications

This is not very common although it can take place and usually when proper care is not observed. Here’s a detailed overview:

Infection

• UTI (Urinary Tract Infection) or bladder infection may be developed in case the catheter or place of insertion is not clean.
• The catheter site of insertion can also become infected with the skin as well.

Bleeding

• In the beginning, minor bleeding occurs at the puncture.
• There are a few instances where one may become very much bloody in case a blood vessel is damaged in the process.

Catheter-Related Issues

• Obstruction or obstruction of the catheter by sediment or blood clots.
• Removal or removal of the catheter accidentally.
• Perineal catheter leakage.

Injury to Nearby Organs

• In rare instances, the operation may cause injury to the bowel, intestines or blood vessels particularly when the bladder is not full at the time of insertion.

Bladder Spasms

• The catheter insertion can cause pain to the patients with bladder spasms.

Long-Term Complications

• Bladder stones caused by protracted catheter insertion.
• Leakage of urine in the area of the catheter.
• Rare cases of formation of a persistent fistula (abnormal connection).

Pain and Discomfort

• Slight pain at the place of insertion is a manifestation that is usually short-lived.
• In case of improper positioning of the catheter, chronic discomfort may develop.

Suprapubic Cystostomy Catheter Care

To avoid infection, obstruction, or any other complication, Suprapubic Cystostomy (SPC) Catheter Care is crucial. Proper care makes sure that the catheter works efficiently as well as is comfortable to the patient.

Daily Cleaning

• Wash the area of the skin where the insertion has been done lightly with soap and water every day.
• Wipe the place to avoid irritation or infection of the skin.
• Do not put ointments unless under a physician’s direction.

Catheter Maintenance

• Determine whether the catheter tubing is kinked or blocked.
• Make sure that the catheter empties freely to the urine bag.
• Take out the urine bag when it gets full (when it is typically 2/3 full).

Preventing Infection

• Wash hands with the catheter or drainage bag.
• To avoid backflow, maintain a position of the catheter and urine bag below the bladder.
• Do not remove catheter off the bag when not necessary.

Catheter Replacement

• The doctor should have a schedule on which the catheter is to be changed (long term use is usually after every 4-6 weeks).
• Do not attempt to dismantle the catheter by yourself.

Complications Surveillance

Watch for:

• The presence of redness, swelling, or discharge in the insertion site.
• Foul-smelling urine
• Fever or pain
• Leakage around the catheter
• Disclose any of these to a medical practitioner.

Activity and Lifestyle

• Do not engage in extreme activity or motion that makes the catheter to be pulled.
• Clothes should be loose so as not to irritate.
• Keep hydrated in order to minimize the chances of a blockage.

Special Precautions

• Always secure the catheter by tying or clamping, without medical recommendation.
• Always have the urine bag fastened when changing position or going to sleep.

Conclusion

Suprapubic cystostomy is a safe and efficient procedure of draining urine when normal urination is impossible/unadvised, especially in cases of urinary retention, urethral obstruction, neurogenic bladder, and post-pelvic/urethral surgery. It has multiple benefits compared to urethral catheterization, such as a lower risk of infection, a higher degree of comfort, and adequacy in the case of the management of a bladder over an extended period. Nonetheless, as any medical intervention, it has certain possible complications, including infection, bleeding, catheter blockage, or damage to the surrounding organs, which may be prevented through adequate surgical practice with focused attention to catheter care. Generally, SPC offers a good and secure remedy to urinary drainage in patients with catheters who are unable to use the urethral pathway when taken care of regularly, maintained hygienically, and replaced punctually.

Why Choose GetWellGo for Suprapubic Cystostomy Treatment?

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We offer:

• Complete transparency
• Fair costs.
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• Assistance in selecting India's top hospitals for Suprapubic Cystostomy treatment.
• Expert urologists with a strong track record of success
• Assistance during and after the course of treatment.
• Language Support
• Travel and Accommodation Services
• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
• Local SIM Cards
• Currency Exchange
• Arranging Patient’s local food

FAQ

1. What is suprapubic cystostomy?

• Suprapubic cystostomy is a surgery where a catheter is placed in the urinary bladder via the lower belly, above the pubic bone, to pass urines in the event of inability to pass urine normally.

2. What is the maximum length of stay of the catheter?

• Normally, a suprapubic catheter may last weeks to months, although it is advisable to change it routinely (at least every 4-6 weeks) under the care of the physician.

3. Is the procedure painful?

• Anaesthesia normally causes minimal pain. Minor pain or some level of discomfort at the location of insertion may be experienced after the procedure but this normally fades with time.

4. Is it possible to have active patients with SPC?

• Yes, patients are able to move and carry out their daily activities but not to a strenuous activity that would be pulling the catheter.

5. Is SPC permanent?

• Depending on the underlying condition it can be both temporary and long-term. In other instances, it is removed after the obstruction in the urethra or a problem in the bladder is eliminated.