Nationwide review of suprapubic catheter insertion and the risk of bowel injury
BAUS ePoster online library. Hall S. 06/26/19; 259498; P13-4
Ms. Susan Hall
Ms. Susan Hall
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Abstract
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INTRODUCTION

Limited data exists on the risks of complication associated with suprapubic catheter (SPC) insertion. Bowel injury is a well-recognised albeit uncommon complication. Guidelines on the insertion of SPC have been developed, but there remains little evidence regarding the incidence of this complication. This study uses contemporary UK data to assess the incidence of SPC insertion and the rate of bowel injury or death.

Patients and Methods
We searched National Hospital Episodes Statistics data on all SPC insertions over an 18month period for OPCS Code M38.2 (Cystostomy and insertion of suprapubic tube into bladder). Patients age, 30day readmission rates, mortality rate within 1 month and catheter specific complication rate were collected.
To estimate bowel injury rate, we searched patients who had undergone any laparotomy or bowel operation within 30 days of SPC insertion. Trusts were contacted directly by the authors and directed to ascertain whether there was SPC-related bowel injury.

RESULTS

11,473 SPC insertions took place in the UK in the 18 month period. There were 142 cases that had laparotomy within 30days. We have responses from 113 of these cases with one report of SPC insertion related bowel injury.

Conclusions
This is the largest data set reported on SPC insertions showing a lower than previously reported rate of bowel injury. We recommend the use of US in experienced hands could be reserved for cases with impalpable bladder despite adequate distension. We also recommend clinicians use a risk of bowel injury of less than 0.5% when considering SPC insertion.
INTRODUCTION

Limited data exists on the risks of complication associated with suprapubic catheter (SPC) insertion. Bowel injury is a well-recognised albeit uncommon complication. Guidelines on the insertion of SPC have been developed, but there remains little evidence regarding the incidence of this complication. This study uses contemporary UK data to assess the incidence of SPC insertion and the rate of bowel injury or death.

Patients and Methods
We searched National Hospital Episodes Statistics data on all SPC insertions over an 18month period for OPCS Code M38.2 (Cystostomy and insertion of suprapubic tube into bladder). Patients age, 30day readmission rates, mortality rate within 1 month and catheter specific complication rate were collected.
To estimate bowel injury rate, we searched patients who had undergone any laparotomy or bowel operation within 30 days of SPC insertion. Trusts were contacted directly by the authors and directed to ascertain whether there was SPC-related bowel injury.

RESULTS

11,473 SPC insertions took place in the UK in the 18 month period. There were 142 cases that had laparotomy within 30days. We have responses from 113 of these cases with one report of SPC insertion related bowel injury.

Conclusions
This is the largest data set reported on SPC insertions showing a lower than previously reported rate of bowel injury. We recommend the use of US in experienced hands could be reserved for cases with impalpable bladder despite adequate distension. We also recommend clinicians use a risk of bowel injury of less than 0.5% when considering SPC insertion.
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