Safety and efficacy of ultrasound-guided percutaneous suprapubic cystostomy in resource-poor setting: A 7-year review

INTRODUCTION: Percutaneous cystostomy techniques are usually done using disposable sets in developed countries which are not affordable in poor-resource settings. However, the percutaneous technique can be done using reusable trocar or selected big size surgical blades. This is simple, safe, and cost effective in poor-resource setting. The procedure is best done under ultrasound guidance but can also be done blindly in select cases. We present our 7-year experience in ultrasound-guided percutaneous suprapubic cystostomy. MATERIALS AND METHODS: This is a 7-year retrospective review of patients, who had ultrasound-guided percutaneous suprapubic cystostomy at Urology Unit of our institution from January 2010 to December 2016. Disposable cystostomy sets were used for the initial experience, but this was replaced with more cost-effective reusable metallic trocar or selected big size surgical blade methods in the later experience. Data were extracted from procedure register and patients' case notes and entered into pro forma and analyzed using Statistical Package for Social Sciences 20.0 version (2011) for windows (IBM, SPSS Incorporation, Chicago, IL, USA) 20.0 version for Windows. RESULTS: A total number of 135 patients had percutaneous cystostomy, which was ultrasound guided in 134 patients (99.3%). The mean age of the patients was 50.5 ± 23.3 years with a range of 2–90 years. The indications for the procedure include urine retention with failed urethral catheterization in 119 patients (88.1%), urethral injury in 14 patients (10.4%), and urethrocutaneous fistula in 2 patients (1.5%) with spinal cord injury. No major complication was recorded. CONCLUSION: Ultrasound-guided suprapubic cystostomy using reusable trocar or selected surgical blade is simple, safe, effective, and associated with minimal complications in poor-resource setting.