A suprapubic cystostomy or suprapubic catheter (SPC) (also known as a vesicostomy or epicystostomy) is a surgically created connection between the

urinary bladder The urinary bladder, or simply bladder, is a hollow organ in humans and other vertebrates that stores urine from the kidneys before disposal by urination. In humans the bladder is a distensible organ that sits on the pelvic floor. Urine enters ...

and the skin used to drain

urine Urine is a liquid by-product of metabolism in humans and in many other animals. Urine flows from the kidneys through the ureters to the urinary bladder. Urination results in urine being excretion, excreted from the body through the urethra. Cel ...

from the bladder in individuals with obstruction of normal urinary flow. The connection does not go through the

abdominal cavity The abdominal cavity is a large body cavity in humans and many other animals that contains many organs. It is a part of the abdominopelvic cavity. It is located below the thoracic cavity, and above the pelvic cavity. Its dome-shaped roof is the th ...

. Urinary flow may be blocked by swelling of the prostate (

benign prostatic hypertrophy Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss o ...

), traumatic disruption of the

urethra The urethra (from Greek οὐρήθρα – ''ourḗthrā'') is a tube that connects the urinary bladder to the urinary meatus for the removal of urine from the body of both females and males. In human females and other primates, the urethra con ...

congenital defects A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can r ...

of the

urinary tract The urinary system, also known as the urinary tract or renal system, consists of the kidneys, ureters, bladder, and the urethra. The purpose of the urinary system is to eliminate waste from the body, regulate blood volume and blood pressure, con ...

, or by obstructions such as

kidney stones Kidney stone disease, also known as nephrolithiasis or urolithiasis, is a crystallopathy where a solid piece of material (kidney stone) develops in the urinary tract. Kidney stones typically form in the kidney and leave the body in the urine s ...

passed into the urethra, and

cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...

. It is also a common treatment used among spinal cord injury patients who are unable or unwilling to use intermittent catheterization to empty the bladder, and cannot otherwise void due to

detrusor sphincter dyssynergia Bladder sphincter dyssynergia (also known as detrusor sphincter dyssynergia (DSD) (the ICS standard terminology agreed 1998) and neurogenic detrusor overactivity (NDO)) is a consequence of a neurological pathology such as spinal injury or multipl ...

. Initially, a thin tube (

catheter In medicine, a catheter (/ˈkæθətər/) is a thin tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. Cath ...

) is placed through the skin just above the

pubic bone In vertebrates, the pubic region ( la, pubis) is the most forward-facing (ventral and anterior) of the three main regions making up the coxal bone. The left and right pubic regions are each made up of three sections, a superior ramus, inferior ra ...

into the bladder, often with the assistance of

ultrasound Ultrasound is sound waves with frequency, frequencies higher than the upper audible limit of human hearing range, hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hea ...

imaging. This catheter initially remains in place for up to a month while the tissue around it scars and forms a tract (

sinus Sinus may refer to: Anatomy * Sinus (anatomy), a sac or cavity in any organ or tissue ** Paranasal sinuses, air cavities in the cranial bones, especially those near the nose, including: *** Maxillary sinus, is the largest of the paranasal sinuses, ...

) between the bladder and the body exterior. After the formation of scar tissue is complete, the catheter is replaced periodically in order to help prevent

infection An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dise ...

Medical uses

* Failed urethral catheter, * Long term usage (if left in urethral long terms catheters can lead to acquired

hypospadias Hypospadias is a common variation in fetal development of the penis in which the urethra does not open from its usual location in the head of the penis. It is the second-most common birth abnormality of the male reproductive system, affecting abou ...

and recurrent/chronic UTIs,

urinary tract infection A urinary tract infection (UTI) is an infection that affects part of the urinary tract. When it affects the lower urinary tract it is known as a bladder infection (cystitis) and when it affects the upper urinary tract it is known as a kidney ...

s).

Contraindications

* Need to rule out bladder cancer in cases of clot retention * Lower abdominal incisions with likelihood of adhesions * Pelvic fracture

Complications

* UTIs * Blockage * Bladder stones * Bladder cancer * Bypass track by urine

Society and culture

The "suprapubic cystotomy" is a specialty of the fictional physician

Stephen Maturin Stephen Maturin () is a fictional character in the Aubrey–Maturin series of novels by Patrick O'Brian. The series portrays his career as a physician, naturalist and spy in the Royal Navy during the Napoleonic Wars, and the long pursuit of hi ...

Patrick O'Brian Patrick O'Brian, Order of the British Empire, CBE (12 December 1914 – 2 January 2000), born Richard Patrick Russ, was an English novelist and translator, best known for his Aubrey–Maturin series of sea novels set in the Royal Navy during t ...

's twenty-one volume series on the

Royal Navy The Royal Navy (RN) is the United Kingdom's naval warfare force. Although warships were used by English and Scottish kings from the early medieval period, the first major maritime engagements were fought in the Hundred Years' War against F ...

during the

Napoleonic era The Napoleonic era is a period in the history of France and Europe. It is generally classified as including the fourth and final stage of the French Revolution, the first being the National Assembly, the second being the Legislative ...

. In modern medical terminology, "cystotomy" without the "s" refers to any surgical incision or puncture into the bladder, such as to remove urinary calculi or to perform tissue repair and reconstruction. "Cystostomy" is surgery specifically to provide drainage.

References

External links