Fluoroscopically Guided Suprapubic Cystostomy in Complex Urologic Cases

Abstract

To evaluate the efficacy of percutaneous suprapubic cystostomies performed by the interventional radiologist for complex urologic cases. A retrospective analysis was done of the 25 cases referred to the radiology department for suprapubic cystostomies. The patients were referred because of unsuccessful placement or malposition of a suprapubic cystostomy tube. The procedure was performed with the Seldinger technique by using a 21-gauge needle for initial antegrade puncture and subsequent tract dilation and placement of 10-24-F catheters. In 24 of 25 cases (96%) the suprapubic cystostomy was successfully performed. After suprapubic cystostomy, eight patients (32%) underwent additional ancillary procedures by urologists through the suprapubic tract. The only major complication was perivesical fluid collection in one patient (4%), which was subsequently drained. Seventeen patients (68%) had transient hematuria. Percutaneous suprapubic cystostomy performed under fluoroscopic control is an effective and safe procedure ideally suited for the interventional radiologist, especially in complex urologic cases.