SUPRAPUBIC CATHETER

Randomized Control Trial of Urethral versus Suprapubic Catheter

Sini Joyce

UCLAN

Abstract

This paper attempts to explore the concept of suprapubic catheter in a holistic context. The paper involves a research study on randomized control trial of urethral versus suprapubic catheter. The paper is about the use of catheterization of pelvic surgery that intends to prevent urinary retention and its associated long-term risks. Numerous factors have also been identified which predispose patients to developing voiding difficulties following pelvic surgery. Furthermore, the paper discusses the methodology, results, and recommendations for further research in the field (Rock, 2007).

Randomized Control Trial of Urethral versus Suprapubic Catheter

Introduction

Urinary catheters are used to drain the bladder. Health care provider recommends a catheter for short-term or long-term use because of Urinary incontinence that is leakage of urine or the inability to control when you urinate. Urinary retention means when a person is unable to empty the bladder. Surgery that made a catheter necessary, such as prostate or gynaecological surgery. Other medical conditions such as multiple sclerosis, spinal cord injury, or dementia alos comes under this. Catheters come in many sizes, materials (latex, silicone, Teflon), and types. A Foley catheter, for example, is a soft, plastic or rubber tube that is inserted into the bladder to drain the urine(Robinson et.al, 2004).

Literature Review

The article is a randomised control trail study about the use of catheterization of pelvic surgery that is intended to prevent urinary retention and its associated long-term risks. Numerous factors have been identified which predispose patients to developing voiding difficulties following pelvic surgery. These involve pain and periurethral oedema, use of regional anaesthesia and/or opiates, anatomical changes as a result of bladder neck surgery, abnormalities of detrusor function and clot retention. In most units, indwelling catheterization via urethral or suprapubic routes has been the standard method of bladder drainage following urogynaecological surgery. The usual practice of Durham (2004) has been routine insertion of an indwelling suprapubic catheter in theatre, with catheterization discontinued when normal voiding has resumed. He defined normal voiding to be voided volumes greater than 200 mls and residual urine volumes less than 100 mls on three occasions. Durham (2004) discusses that Suprapubic catheterization involves the insertion of an indwelling catheter through the anterior abdominal wall and into the dome of the bladder. Urethral integrity is maintained and allows for the resumption of normal voiding, when the suprapubic catheter is clamped postoperatively(Farnham et.al, 2007).

In women who are unable to void, the catheter may be unclamped, thereby allowing continuing bladder drainage without the need for re-catheterization. Gray and Malone (1995) defined the intermittent catheterization as an alternative to indwelling suprapubic catheter as a means of ensuring adequate bladder drainage when a patient is unable to void spontaneously after surgery. This technique involves episodic urethral catheterization, with the patient remaining catheter-free between drainage episodes. Both of these catheterization techniques are aimed at the prevention of post-operative urinary retention and the long-term risks arising from bladder over-distention. However, Rock (2007) said that catheterization itself has an associated morbidity, particularly ...