Suprapubic Tube Complications Using the Percutaneous Trochar Approach: A Case Series

Suprapubic Tube (SPT) catheters are common urinary diversion techniques for long term maintenance of bladder dysfunction. Multiple SPT placement techniques exist, including open, image-guided, or cystoscope-guided, using either a Seldinger or trochar approach. This case series includes six patients (3 males/3 females, average age = 58.2 years) with neurogenic bladder who underwent SPT placement via trochar technique with subsequent complications. Complications were graded using the Clavien-Dindo (CD) classification and included hematuria, catheter malposition or dislodgement, and organ perforation. Key potential risk factors include history of neurogenic bladder, previous chronic indwelling catheter, altered/abnormal urethral or bladder anatomy, concurrent anticoagulant use, obesity, and prior abdominal surgery. While SPT placement has utility in bladder management, placement with trochar techniques can lead to significant complications. Risk factors must be carefully considered in all patient candidates and alternative placement options via an open approach or with imaging guidance should be considered in select patients.