title: Ultrasound-guided suprapubic cystostomy catheter placement in the emergency department.
abstract: The purpose of this article is to describe a series of patients undergoing ultrasound-guided suprapubic cystostomy catheter placement in the Emergency Department. A series of 17 consecutive patients who underwent emergent real-time ultrasound-guided suprapubic cystostomy in the ED over a 2-year period is reported. The procedure was facilitated by direct ultrasound imaging of the bladder using a Digital Sonoace 5500 machine. Procedural notes and follow-up records were analyzed for efficacy, safety, and complications. The results demonstrated that trans-abdominal ultrasound confirmed urinary retention before drainage in each of the 17 cases enrolled. Each patient required emergent suprapubic cystostomy catheter placement for acute urinary outflow obstruction because urethral bladder catheterization was not possible or was contraindicated. Continuous real-time ultrasound-guided percutaneous suprapubic cystostomy placement and decompression of the bladder was successful in all 17 (100%, 90-100% CI: 95%) cases. There were no complications reported. In conclusion, real-time ultrasound imaging of the bladder was successful for the purpose of aiding the guidance of a suprapubic cystostomy catheter placement in the ED and might represent an improvement from the standard blind method presently used.
authors.affiliation: Martin Luther King Jr./Drew Medical and Trauma Center, Charles R. Drew University of Medicine, Los Angeles, California 90254, USA.
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Aguilera
authors.forename: Toni
authors.initials: T
authors.lastname: Choi
authors.forename: Brittan A
authors.initials: BA
authors.lastname: Durham
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003559:Cystostomy / Q000379:methods*; D019299:Decompression, Surgical / Q000379:methods; D004635:Emergency Medicine / Q000379:methods*; D004636:Emergency Service, Hospital; D006801:Humans; D008297:Male; D008875:Middle Aged; D010688:Phimosis / Q000150:complications; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000150:complications; D011471:Prostatic Neoplasms / Q000150:complications; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*; D014525:Urethral Stricture / Q000150:complications; D014546:Urinary Catheterization / Q000379:methods*; D016055:Urinary Retention / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*