title: SUPRAPUR(®): Safe and convenient percutaneous suprapubic catheterisation in high-risk patients.
abstract: BACKGROUND
  Ultrasound-guided percutaneous placement of a suprapubic cystostomy is a common and generally safe procedure in everyday surgery. In case of adverse patient characteristics such as small bladder capacity or high body mass index, however, the procedure carries an increased risk of severe complications, including bowel perforation. The Suprapur(®) cystostomy set is supposed to enable a safer procedure. The aim of our work was to evaluate the safety and ease of use of the Suprapur(®) cystostomy set.
  
  
  METHODS
  We prospectively evaluated the Suprapur(®) set in high-risk patients, having either a small bladder capacity below 250 ml or a BMI above 30 kg/m(2). Complications and surgical outcome were monitored. In addition, patients' contentment and pain during the procedure was assessed with a visual analogue scale (VAS). Possible drawbacks and ease of use were evaluated by customized questionnaires for the operating physician.
  
  
  RESULTS
  In total, 26 cystostomies were performed by 15 different physicians, 40% (n = 6) of whom were inexperienced first or second year residents. No complications occurred. Mild gross haematuria occurred in 11.5% (n = 4) of cases. Average VAS for pain during and two hours after the procedure was 2.1 (±1.2) and 0.3 (±0.5) respectively. In 91%, (n = 20) of the procedures, the physicians claimed to have felt safe using SUPRAPUR(®) and more comfortable (82%, n = 18) than with a conventional cystostomy set.
  
  
  CONCLUSIONS
  SUPRAPUR(®) allows a safe and simple placement of a suprapubic cystostomy even in high-risk patients or in inexperienced hands. It might help to reduce the complications of a common and frequent surgical procedure.
authors: Department of Urology, University Medical Center Mannheim, Mannheim, Germany.
authors: Maximilian Christian
authors: MC
authors: Kriegmair
authors: Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors: Philipp
authors: P
authors: Mandel
authors: Department of Urology, University Medical Center Mannheim, Mannheim, Germany.
authors: Manuel
authors: M
authors: Ritter
keywords: bladder drainage; complications; high-risk patients; suprapubic cystostomy