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

urinary bladder The bladder () is a hollow organ in humans and other vertebrates that stores urine from the Kidney (vertebrates), kidneys. In placental mammals, urine enters the bladder via the ureters and exits via the urethra during urination. In humans, the ...

and the skin used to drain

urine Urine is a liquid by-product of metabolism in humans and many other animals. In placental mammals, urine flows from the Kidney (vertebrates), kidneys through the ureters to the urinary bladder and exits the urethra through the penile meatus (mal ...

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 contain Organ (anatomy), organs. It is a part of the abdominopelvic cavity. It is located below the thoracic cavity, and above the pelvic cavity. Its dome-shaped roo ...

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

benign prostatic hyperplasia 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, urinary retention, inability t ...

), traumatic disruption of the

urethra The urethra (: urethras or urethrae) is the tube that connects the urinary bladder to the urinary meatus, through which Placentalia, placental mammals Urination, urinate and Ejaculation, ejaculate. The external urethral sphincter is a striated ...

, congenital defects of the urinary tract, or by obstructions such as

kidney stones Kidney stone disease (known as nephrolithiasis, renal calculus disease, or urolithiasis) is a crystallopathy and occurs when there are too many minerals in the urine and not enough liquid or hydration. This imbalance causes tiny pieces of cr ...

passed into the urethra, and

cancer Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po ...

. 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. Initially, a thin tube (

catheter In medicine, a catheter ( ) is a thin tubing (material), 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. ...

) is placed through the skin just above the

pubic bone In vertebrates, the pubis or pubic bone () forms the lower and anterior part of each side of the hip bone. The pubis is the most forward-facing (ventral and anterior) of the three bones that make up the hip bone. The left and right pubic bones ar ...

into the bladder, often with the assistance of

ultrasound Ultrasound is sound with frequency, frequencies greater than 20 Hertz, kilohertz. This frequency is the approximate upper audible hearing range, limit of human hearing in healthy young adults. The physical principles of acoustic waves apply ...

imaging. This catheter initially remains in place for up to a month while the tissue around it scars and forms a tract ( sinus) 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 tissue (biology), tissues by pathogens, their multiplication, and the reaction of host (biology), host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmis ...

Medical uses

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

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

and recurrent/chronic UTIs,

urinary tract infection A urinary tract infection (UTI) is an infection that affects a part of the urinary tract. Lower urinary tract infections may involve the bladder (cystitis) or urethra (urethritis) while upper urinary tract infections affect the kidney (pyel ...

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 ...

Patrick O'Brian Patrick O'Brian (12 December 1914 – 2 January 2000), born Richard Patrick Russ, was an English novelist and translator, best known for his Aubrey–Maturin series. These sea novels are set in the Royal Navy during the Napoleonic Wars and ...

's twenty-one volume series on the

Royal Navy The Royal Navy (RN) is the naval warfare force of the United Kingdom. It is a component of His Majesty's Naval Service, and its officers hold their commissions from the King of the United Kingdom, King. Although warships were used by Kingdom ...

during the

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

. 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