Thomas Wong, MD: No financial relationships to disclose
David P. Duncan, M.D.: No financial relationships to disclose
Learning Objectives:
Review techniques with which IRs may utilize to place suprapubic tubes
Pictorial overview of the balloon-assisted suprapubic tube placement technique
Background:
IRs work in conjunction with urologists to manage bladder outlet obstruction or to create urinary diversion prior to urethral intervention
Urinary diversion by suprapubic tube can be achieved using various catheters, including pigtail drains, standard and Council Foley catheters, and depending on catheter selected, by utilizing specific techniques.
A Council catheter is a type of Foley Catheter with an end-hole, allowing it to track over a guidewire.
Primary placement of a standard or Council Foley catheter saves patients additional upsizing procedures, sometimes which occur in the operating room under general anesthesia.
Clinical Findings/Procedure Details:
Pigtail drains and Foley catheters require serial dilation, but Foley catheters cannot track over a guidewire and thus ultimately require placement through a peel-away sheath.
Angioplasty balloons may be utilized to dilate the suprapubic tract and help “railroad” a Council Foley catheter in a single motion.
Pictorial overview of balloon-assisted suprapubic catheter placement.
Conclusion and/or Teaching Points:
Primary placement of standard or Council Foley catheters as suprapubic tubes obviates the need for secondary procedures to exchange/upsize.
Balloon-assisted suprapubic tube placement, which can be done entirely with ultrasound guidance, is a quick and efficient method for primary placement of standard and Council Foley suprapubic tubes
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