Korean J Urol.  2010 Dec;51(12):847-852.

Rethinking Suprapubic Cystostomy in Voiding Dysfunction: New Trial with Timed Drainage

• Park HC
• Son JH
• Jang SH

Abstract

PURPOSE
Today, many patients with voiding dysfunction select suprapubic cystostomy (SPC) instead of clean intermittent catheterization (CIC) for practical reasons. There is thus a need to reconsider SPC as a management for voiding dysfunction. We designed SPC with timed drainage (TSPCD) and evaluated its effectiveness compared with continuous drainage with a urine bag (CSPCD).
MATERIALS AND METHODS
Between January 2006 and January 2010, a total of 82 patients underwent SPC. Patients undergoing SPC were randomly assigned to CSPCD or TSPCD. Patient characteristics, complications, and the results of urine cultures were compared between the two groups through retrospective chart reviews. Also, preferences for CSPCD and TSPCD in another 15 patients who had experienced both CSPCD and TSPCD were investigated.
RESULTS
The CSPCD and TSPCD groups comprised 46 and 36 patients, respectively. In a comparison of complications between the two groups, the incidence of acute symptomatic cystitis was significantly lower in the TSPCD group than in the CSPCD group (43% vs. 20%, p=0.032). The incidence of symptomatic urinary tract infection (UTI) was lower in the TSPCD group. Positive urine culture rates were 89.7% and 72.4% in groups 1 and 2, respectively. There was a significant difference between the two groups (p=0.004). In another 15 patients who experienced both CSPCD and TSPCD, 14 patients (93%) stated a preference for TSPCD after converting from CSPCD to TSPCD, and one patient (7%) returned to CSPCD only at night.
CONCLUSIONS
In this study, TSPCD had the advantages of less morbidity as UTI and being more preferable by patients with relatively good daily activity compared with CSPCD. TSPCD is an alternative to CSPCD for the treatment of voiding dysfunction.

Keyword

Cystostomy; Dysfunction; Urinary bladder

MeSH Terms

Cystitis
Cystostomy
Drainage
Humans
Incidence
Intermittent Urethral Catheterization
Retrospective Studies
Urinary Bladder
Urinary Tract Infections

Figure

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  FIG. 1 Longitudinal changes in bladder management for voiding dysfunction in this study. SPC: suprapubic cystostomy, CIC: clean intermittent catheterization.

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