Ultrasound-guided Suprapubic Catheterisation (USPC): Technique, outcomes, and cost-effectiveness
BAUS ePoster online library. Qamhawi Z. 11/11/20; 304231; P13-3 Disclosure(s): This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Dr. Zahi Qamhawi
Dr. Zahi Qamhawi
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Ultrasound-guided Suprapubic Catheterisation (USPC): Technique, outcomes, and cost-effectiveness

Qamhawi Z1, Briggs J1, Little M1, Ahmad F1, Gibson M1, Kumar P2, Speirs A1
1Department of Interventional Radiology, Royal Berkshire Hospital, Reading, United Kingdom, 2Harold Hopkins Department of Urology, Royal Berkshire Hospital, Reading, United Kingdom

Introduction:
Suprapubic catheterisation (SPC) is an alternative to transurethral catheterisation for long-term bladder drainage. The procedure is mostly performed under general anaesthesia with cystoscopic visualisation. However, ultrasound-guided suprapubic catheterisation (USPC) using local anaesthesia may be a suitable alternative. This study aims to assess clinical outcomes and cost-effectiveness of USPC in interventional radiology compared to cystoscopy-guided insertion in theatre.
Materials and Methods: A retrospective analysis was conducted of 124 USPC and 31 cystoscopy-guided procedures over a 2-year period. Technical success, clinical success, and the 30-day complication rate were compared. The cost-effectives ratio (CER=Procedural Cost/Effectiveness Index) for each method was calculated.

Results:
Technical success in the USPC cohort was 94.4% compared to 93.5% with cystoscopy-guidance (p-value n.s.). Clinical success with USPC was 91.6% compared to 96.6% with cystoscopy (p-value n.s.). The rate of major complications was comparable between USPC and cystoscopy-guided insertion (10.9% vs. 17.2%; p-value n.s.). No bowel injury occurred. The rate of overall minor complications and minor urinary tract infections was significantly higher with cystoscopy (44.8% vs. 19.4%; 13.8% vs. 3.4%; p<0.05), although such complications may have been better detected in the cystoscopy cohort who were predominately in-patients. USPC was more cost-effective (CER=234.9) than cystoscopy-guided insertion (CER=1082.5), owing to the higher theatre associated costs with cystoscopy.

Conclusion:
USPC demonstrates comparable clinical outcomes to cystoscopy-guided SPC but is considerably more cost-effective. Whilst validation of outcomes would necessitate a prospective case-controlled trial, current findings would support the use of USPC over cystoscopy as the preferred insertion technique for SPC.
Ultrasound-guided Suprapubic Catheterisation (USPC): Technique, outcomes, and cost-effectiveness

Qamhawi Z1, Briggs J1, Little M1, Ahmad F1, Gibson M1, Kumar P2, Speirs A1
1Department of Interventional Radiology, Royal Berkshire Hospital, Reading, United Kingdom, 2Harold Hopkins Department of Urology, Royal Berkshire Hospital, Reading, United Kingdom

Introduction:
Suprapubic catheterisation (SPC) is an alternative to transurethral catheterisation for long-term bladder drainage. The procedure is mostly performed under general anaesthesia with cystoscopic visualisation. However, ultrasound-guided suprapubic catheterisation (USPC) using local anaesthesia may be a suitable alternative. This study aims to assess clinical outcomes and cost-effectiveness of USPC in interventional radiology compared to cystoscopy-guided insertion in theatre.
Materials and Methods: A retrospective analysis was conducted of 124 USPC and 31 cystoscopy-guided procedures over a 2-year period. Technical success, clinical success, and the 30-day complication rate were compared. The cost-effectives ratio (CER=Procedural Cost/Effectiveness Index) for each method was calculated.

Results:
Technical success in the USPC cohort was 94.4% compared to 93.5% with cystoscopy-guidance (p-value n.s.). Clinical success with USPC was 91.6% compared to 96.6% with cystoscopy (p-value n.s.). The rate of major complications was comparable between USPC and cystoscopy-guided insertion (10.9% vs. 17.2%; p-value n.s.). No bowel injury occurred. The rate of overall minor complications and minor urinary tract infections was significantly higher with cystoscopy (44.8% vs. 19.4%; 13.8% vs. 3.4%; p<0.05), although such complications may have been better detected in the cystoscopy cohort who were predominately in-patients. USPC was more cost-effective (CER=234.9) than cystoscopy-guided insertion (CER=1082.5), owing to the higher theatre associated costs with cystoscopy.

Conclusion:
USPC demonstrates comparable clinical outcomes to cystoscopy-guided SPC but is considerably more cost-effective. Whilst validation of outcomes would necessitate a prospective case-controlled trial, current findings would support the use of USPC over cystoscopy as the preferred insertion technique for SPC.
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