Easy Suprapubic Tube Placement Using a Van Buren Sound.

OBJECTIVE: To place a suprapubic tube without using specialized instruments. Suprapubic cystostomy is a straightforward urological procedure, which nevertheless may become complicated if the equipment needed to perform the operation is unavailable. Nowadays, in most operating rooms, control of urological instruments has been taken away from a small cadre of dedicated urology nurses, and instead is delegated to a central sterilization department or is even outsourced, leading to an increased rate of instrument misplacement or breakage. Disposable kits are useful, but may not be stocked at all facilities. Hence, the tools needed by the urologist to perform suprapubic cystostomy may not be readily available when they are needed. This reality was the impetus for the development of the following technique for suprapubic tube placement, which relies only upon ordinary instruments.

METHODS: A simple method is described for placing a suprapubic catheter using a curved Van Buren sound, a cystoscope, and a minor surgical set.

RESULTS: Not only is the operation is easy to do, but is also advantageous in that the catheter may be exchanged over a wire, if necessary, before the establishment of a suprapubic tract. The technique depends on the presence of an intact urethra; therefore, it is contraindicated in the setting of pelvic trauma.

CONCLUSION: This suprapubic cystostomy method may be used either as a primary technique or as a back-up procedure if the urologist's preferred instrumentation is not available.