Suprapubic Cystostomy (SPC)
Suprapubic tube drainage of the bladder through a small lower abdominal puncture — rapid, safe emergency or long-term bladder drainage when urethral catheterisation is not possible.
What is Suprapubic Cystostomy (SPC)?
Suprapubic Cystostomy (SPC) places a drainage tube directly into the bladder through a small puncture or incision in the lower abdominal wall, just above the pubic symphysis. It is performed under local anaesthesia or sedation when urethral catheterisation is not possible or is contraindicated — such as urethral trauma, severe stricture, false passage, or acute prostatitis. SPC provides immediate bladder decompression within minutes, avoids urethral trauma, and allows the urethra to recover while definitive treatment is planned. Long-term SPC management is appropriate for patients with permanent voiding dysfunction who cannot perform urethral catheterisation.
How the Procedure Works
Bladder Filling Confirmation
Bladder confirmed adequately filled by ultrasound or palpation; a minimum of 300 mL is required for safe percutaneous puncture.
Local Anaesthesia
Skin, subcutaneous tissue, and anterior bladder wall infiltrated with local anaesthetic at planned puncture site 2–3 cm above pubic symphysis in the midline.
Needle Puncture
Introducer needle advanced perpendicular to skin into bladder lumen; urine aspiration confirms correct position before guidewire insertion.
Tube Placement
SPC tube placed over guidewire or through trocar into bladder; balloon or pigtail retains the tube; connected to drainage bag immediately.
Securing & Care
Tube secured to skin with suture and adhesive dressing; patient taught tube care before discharge; tube changed at 6–8 weeks as outpatient.
Outcomes
Who Needs This Treatment?
- →Patients in acute urinary retention where urethral catheterisation has failed after one or more attempts.
- →Those with urethral trauma, pelvic fractures, or complete urethral disruption where urethral passage is unsafe.
- →Men with acute prostatitis where urethral catheterisation risks introducing infection or worsening inflammation.
- →Patients with severe urethral strictures where any urethral instrumentation risks creating a false passage.
- →Those requiring urethral rest after urethroplasty or urethral reconstruction during the healing period.
- →Patients with permanent voiding dysfunction who cannot perform urethral self-catheterisation independently.
"Suprapubic cystostomy is one of the most immediately gratifying procedures in urology — a patient in severe painful retention is completely relieved within minutes of placement. Its simplicity belies its enormous clinical importance."
— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon
Common Questions
Frequently Asked
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