Ultrasound Guided Suprapubic Catheter Insertion

You might need a suprapubic catheter if you have a condition that stops you from being able to empty your bladder in the normal way. Long-term catheterisation may be necessary if you are incontinent or have urethral damage, as well as following certain types of gynaecological operations.

For some patients ultrasound guided insertion may be the only option. This can be the case if you require long-term catheterisation and are considered too high risk to have a general anaesthetic. It may also happen if there is a heightened risk of bowel injury, for example due to previous abdominal surgery.

Ultrasound guided suprapubic catheter insertion is performed under local anaesthetic. This means you will be awake throughout the procedure but won’t be able to feel any pain. We anaesthetise the whole area, from the skin to the lining of the bladder. You may also be given sedation to help you to relax. Once the area is numb, a small incision is made in your abdomen and the catheter is inserted.

By using ultrasound to help us to position the catheter (rather than a cystoscope to look inside the bladder as with conventional surgical insertion), the procedure is more comfortable and less invasive.

Doctors use ultrasound to guide the positioning of the suprapubic catheter. This helps to minimise the risk of serious complications, such as bowel injury which can occur during a surgical insertion in theatre.

Suprapubic catheters are more comfortable and easier to look after than normal urethral catheters. They don’t damage the urethra, have lower rates of infection and once established are more comfortable to exchange. They allow normal sexual function and can be used to retrain the bladder.

The risks associated with ultrasound guided insertion are generally lower than surgical insertion in theatre. This is because the former is a minimally-invasive procedure performed under local rather than general anaesthetic.

Our highly qualified consultants have performed more than 250 ultrasound guided suprapubic catheter insertions. They recently published a paper in BAUS 2020. We are supported by a team of specialist urology nurses who assist with the procedure and can advise on aftercare.

There are a small number of risks associated with suprapubic catheters. These include infection and the catheter becoming blocked. They also include soreness or discomfort around the catheter site and blood in the urine when the catheter is changed. Our urology nurses will advise you on the best way to look after a suprapubic catheter to prevent problems from occurring.