When placement of a urethral catheter is contraindicated or unsuccessful, percutaneous suprapubic urinary bladder catheterization is commonly performed to relieve urinary retention.
Indications include: urethral injuries urethral obstruction, bladder neck masses, benign prosthetic hypertrophy and prostate cancer.
The procedure is contraindicated in the absence of a palpable or ultrasonographically localized distended urinary bladder.
Relatively contraindicated in the presence of a coagulopathy, where previous abdominal/pelvic surgery, or the presence of pelvic cancer with or without radiation that may be associated with adhesions to the bladder or anterior abdominal wall.
Ultrasonographic examination to localize the bladder is recommended for catheter placement.
Cystoscopy may be used to facilitate catheterization when it is difficult to identify the bladder.
Gross hematuria is common after the placement of a suprapubic catheter.
Bowel perforation and intra-abdominal visceral injuries are possible with catheter placement.