MP74-14 SUPRAPUBIC CATHETER DRAINAGE FOR THE LONG-TERM MANAGEMENT OF LOWER URINARY TRACT DYSFUNCTION: LONGITUDINAL OUTCOMES AND UTILIZATION PATTERNS FROM A TERTIARY CARE PRACTICE

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP74-14 SUPRAPUBIC CATHETER DRAINAGE FOR THE LONG-TERM MANAGEMENT OF LOWER URINARY TRACT DYSFUNCTION: LONGITUDINAL OUTCOMES AND UTILIZATION PATTERNS FROM A TERTIARY CARE PRACTICE Faizan Khawaja, Kevin Flynn, Mei Tuong, Charles Schlaepfer, Andrew Metzger, and Bradley Erickson Faizan KhawajaFaizan Khawaja More articles by this author , Kevin FlynnKevin Flynn More articles by this author , Mei TuongMei Tuong More articles by this author , Charles SchlaepferCharles Schlaepfer More articles by this author , Andrew MetzgerAndrew Metzger More articles by this author , and Bradley EricksonBradley Erickson More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003348.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Suprapubic catheters (SPC) are considered to be a temporary, and often emergent, means to drain urine from the bladder. However, many individuals are managed with SPCs for longer periods of time, often because of patient choice. Our objective is to describe this population and report on the long-term outcomes of chronic SPC use for lower urinary tract dysfunction (LUTD). METHODS: An institutional review of CPT and ICD-9/10CM codes was conducted to identify a cohort of patients in which an SPC was placed at our institution over an 8-year period. Patients were then excluded if the SPC was placed emergently for lower urinary tract trauma (e.g. pelvic fracture) or for a pre-determined time-period. The final cohort was then analyzed for peri-operative and long-term complications, and for SPC survivability. RESULTS: Of 370 SPC placed from 2014-21, 190 met inclusion criteria (131 Male; 59 Female). Indications for SPC were most commonly Acquired Neurogenic Bladder (40%), Urinary Retention/Atonic Bladder (27%), Urinary Incontinence (11%) and Congenital Neurogenic Bladder (8%). Bladder management prior to SPC was indwelling urethral catheter (53%), intermittent catheterization (32%) and none (15%). There were no Clavian Grade III/IV complications with placement. Initial clinic SPC exchange was successful in 98% (4 required repeat tract dilation). Subsequent exchanges occurred in urology clinics (54%), care facilities (23%), interventional radiology (12%) and at home by patient (11%) at a median interval of 3.5 weeks. >30 day complications were common (51%), but all Clavian Grade I/II (UTI 27%, bladder spasms 13%). At median follow-up of 431 days, 74% continued to use their SPC (Figure 1), of which 53 (38%) perform daily irrigation. CONCLUSIONS: SPC is a commonly used, well-tolerated, poorly studied means of chronic bladder drainage for a wide-variety of LUTD in patients not suitable or willing to undergo surgical reconstruction. Considered to be a management method of last resort, its popularity amongst patients nonetheless suggests its use should be studied in further detail. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1075 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Faizan Khawaja More articles by this author Kevin Flynn More articles by this author Mei Tuong More articles by this author Charles Schlaepfer More articles by this author Andrew Metzger More articles by this author Bradley Erickson More articles by this author Expand All Advertisement PDF downloadLoading ...