A MODIFIED AND COST EFFECTIVE TECHNIQUE OF PERCUTANEOUS SUPRAPUBIC CYSTOSTOMY IN EMERGENCY
Introduction: In emergency setting in developing countries there are several hospitals in suburban and remote areas where commercially available suprapubic trocar and canula is not available and the surgeon working faces problems in carrying out emergency procedure for acute retention of urine. The solution is to evolve a procedure which is easy to perform, involves minimum number of instruments, needs less expertise, requires minimum dissection, with minimum or no assistance and can be done with ease at any place. We are describing a simplified technique of percutaneous supra-pubic cystostomy which fulfills above criteria’s as well is cost effective.
Material and Methods: The study was carried out from January 2011 to January 2014 in a tertiary care institute of central India. This technique was used in 78 patients in emergency. All the patients presented with retention of urine may be acute or acute on chronic retention where per-urethral catheterization failed, these patients were subjected to Suprapubic cystostomy under local anesthesia. The outcome and success rate were studied and evaluated.
Results: The mean age of the patients was 61 years (range 28-96 years).These patients were admitted in emergency with acute urinary retention and failed per-urethral catheterization. Successful bladder puncture and catherization with foleys catheter was done in all the cases in emergency with this modified technique. There was no visceral injury or mortality in our series. Three patients had blockage in urine outflow due to clot retention which was flushed and relived.
Conclusion: The early experience of this technique is promising safe and effective yet randomized multi-centric trial will be needed to popularize this technique for its wide spread acceptance. The technique is safe, cheap easy to manage, consumes less time and involves use of pre-sterilized, instruments which minimizes the risk of diseases as HIV and hepatitis.
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