Suprapubic Catheter Placement


Suprapubic Catheter Placement Basics

Dr. Valeria Chew 



Need for bladder drainage / irrigation in a patient with: 

     - Urethral injuries (iatrogenic, trauma) 

     - Urethral strictures 

     - Obstructing prostate disease 

     - Obstructing lesions (ie malignancy) 

     - Phimosis 

     - Urethral foreign body 



     - Empty bladder (or unable to visualize)

     - Bowel anterior to bladder 

     - Overlying infection/lesions 


What you’ll need 

     - Ultrasound 

     - Analgesia (lidocaine) 

     - Urine bag 

     - Foley catheter  

     - Sterile syringe 

     - Scalpel 

     - Sterile gloves 

     - Skin prep (chlorhexidine, etc) 

     - Dressing 

     - Peel away catheter:


           **If you don’t have this, use Seldinger technique with central access kit 



     1. Ultrasound, visualize bladder 

     2. Prep 

     3. Numb site with wheal 

     4. Use spinal needle & negative pressure on syringe, when you hit urine, stop

     5. Guidewire through needle, remove needle 

     6. Scalpel to open site 

     7. Place introducer and in-dwelling dilator, remove dilator 

     8. Put foley into introducer, peel introducer it away 

     9. Aspirate foley to confirm placement, Inflate balloon

     10. Dress site 

     11. Attach urine bag of choice 


** For emergent decompression without a foley, aspirate urine at step 4 and stop if needed.  






Aguilera PA, Choi T, Durham BA: Ultrasound-guided suprapubic cystostomy catheter placement in the emergency department. J Emerg Med 2004;26(3):319–321. 


Suprapubic Bladder Catheterization (Percutaneous Cystostomy). In: Reichman EF. Reichman E.F.(Ed.),Ed. Eric F. Reichman.eds. Emergency Medicine Procedures, 2e. McGraw Hill; 2013. Accessed October 01, 2021.