Long Term Follow up of Suprapubic Cystostomy

ABSTRACT

PURPOSE: We assessed the clinical significance of suprapubic cystostomy in the treatments of patients with voiding difficulty and analyzed the complications of it and their courses. Also we compared the results with our previous study. PATIENTS AND Methods: We reviewed 30 patients managed with suprapubic cystostomy. The changes in serum Cr, urinary pH and white blood cell values after suprapubic cystostomy were evaluated. We investigated complications of these patient. The stone-free rate after suprapubic catheter insertion was estimated by the Kaplan-Meier method. RESULTS: The original diseases were spinal cord injury in 19 (63.3%), cerebrovascular accident in 3 (10%), inoperable benign prostatic hyperplasia in 2 (6.7%), diabetic cystopathy in 2 (6.7%), recurrent urethral stricture in 2 (6.7%) and prostatic cancer in 2 (6.7%). The most common complication was the formation of the bladder calculi in 8 cases (26.7%). There were no serious complications associated with the procedure and no deterioration of the renal function. The mean serum creatinine level changed from 1.15+/-0.06 mg/dl to 1.13+/-0.07 mg/dl without statistical significance. The stone-free rates 1 and 7 years after the procedure were 96.7% and 73.3%, respectively. The urinary pH of the stone-forming group was significantly higher than that of the stone-free group (p<0.05). CONCLUSION: Suprapubic cystostomy is an alternative method for patients of voiding dysfunction in cases of severe urethral damage or limited activity of upper extremities. In spite of advantage of suprapubic cystostomy, we must make an effort on preventing bladder stone, urinary tract infection in patients with suprapubic catheter.