SUPRAPUBIC-CATHETER-CENTRE
Ultrasound insertion: Day case: No general anaesthetic
ULTRASOUND GUIDED SUPRAPUBIC CATHETER INSERTION
Day case, low risk, procedure under local anaesthetic
Avoids the need for cystoscopy, general anaesthetic or hospital admission
Performed in dedicated private urology building in Reading, Berkshire
Insured, self funding or NHS
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Suprapubic catheters are more comfortable and easier to look after than normal urethral catheters. They don't damage the urethra, have lower rates of infection and once established are more comfortable to exchange. They also allow normal sexual function and permit bladder retraining
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Using ultrasound guidance, we can minimise major complications such as bowel injury which is a small but serious risk during standard surgical insertion in theatre.
Unfortunately not many centres routinely have ultrasound capability for suprapubic catheter insertion, a specialist skill honed by Interventional Radiologists
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Ultrasound guided insertion under local anaesthetic is the only option for patients who are considered too high risk for a general anaesthetic or where there are concerns about possible bowel injury because of previous abdominal surgery
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Patients who have a urethral stricture to be eligible for an ultrasound guided suprapubic catheter
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It is well tolerated under local anaesthetic. We do not use a cystoscope to look into the bladder during the procedure making it more comfortable for patients.
We anaesthetise the lining of the bladder and the new track from the skin to bladder thoroughly at the start of the procedure. Sedation is also available
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OUR TEAM
We are a group of Consultants who work together in both NHS practice at The Royal Berkshire Hospital and private practice in Reading. We commenced our ultrasound guided suprapubic catheter programme in 2017 and having performed nearly 250 cases recently published our results at BAUS 2020. We have a team of specialist urology nurses to assist on the day and advise on any aftercare.
DR. ARCHIE SPEIRS
Consultant Interventional Radiologist
DR. MATTHEW GIBSON
Consultant Interventional Radiologist
DR FARHAN AHMAD
Consultant Interventional Radiologist
DR JAMES BRIGGS
Consultant Interventional Radiologist
PROFESSOR MARK LITTLE
Consultant Interventional Radiologist
MR SUNIL KUMAR
Consultant Urologist
MR STEVE FOLEY
Consultant Urologist
MR. ADAM JONES
Consultant Urologist
MR. PHILIP CHARLESWORTH
Consultant Urologist
MR CHRIS BLICK
Consultant Urologist
MR PAUL HADWAY
Consultant Urologist
The Forbury Clinic, Reading
Dedicated private urology clinic with treatment room
Specialist urology nurses
Ample parking
http://www.readingurologypartnership.com/
PRICE LIST
MEDICAL INSURANCE
We are recognised and fee assured by most major medical insurers. There are no additional payments. Consultations, procedure and follow up included
SELF FUNDING
Initial consultation (virtual) £205
Suprapubic catheter procedure £975
Follow up consultations £165
Routine exchange of catheter £150
NHS
Our NHS practice is at the Royal Berkshire Hospital, Reading. If you are out of area, we are happy to approach your local trust to request funding although this maybe unsuccessful. Alternatively you can self fund.
REFERRALS
We accept direct referrals from Consultants or General Practitioners.
If you are a self funding patient and would like to discuss management of your bladder problems with a Consultant Urologist perhaps with a view to considering a suprapubic catheter please contact us directly.
If you are an insured patient we will need a referral from your GP.
Suprapubic-catheter-centre
Berkshire Imaging
The Forbury Clinic
23 Craven Road
Reading
RG1 5LE
0118 338 2500
COMMON QUESTIONS
WHAT ARE THE ADVANTAGES OF A SUPRAPUBIC CATHETER
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For long-term bladder catheterisaton many patients prefer a suprapubic catheter as opposed to a standard urethral catheter. There are several advantages of a suprapubic catheter:
Lower risk of catheter associated pain
Lower risk of urine infections. A suprapubic catheter is easier to keep clean.
Easier and less painful to exchange once the catheter once the track has matured
Avoids urethral strictures
Higher patient satisfaction
Avoiding the risk of a general anaesthetic and cystoscopy (if inserted using ultrasound)
Avoid the risks of being admitted to hospital (if inserted using ultrasound)
Potentially larger sized catheters can be used which reduces the rate of catheter blocking
WHAT ARE THE RISKS OF A SUPRAPUBIC CATHTER INSERTION?
Although an ultrasound guided suprapubic catheter insertion is generally low risk procedure there are a number of potential complications:
Bleeding. Usually minor bleeding into the urine which settles after a few hours or days. Rarely, this is more significant requiring a short hospital stay. If you are taking blood thinning medication (anticoagulant or antiplatelet tablets) these may need to be temporarily stopped for the procedure
Infection. A small number of patients get urine infections after insertion. If you have an active infection, the procedure maybe delayed and/or antibiotics injected prior to the procedure. Very occasionally infections could require admission for treatment.
Catheter blockage. Occasionally necessitating exchange of the catheter. We use end hole catheters so exchange can easily be achieve over a guidewire.
Pain following insertion. Rarely the catheter will need to be removed
Urine leak. Although use of a suprapubic catheter is designed to treat urine leakage this is not guaranteed.
Bowel injury. This risk is minimised with ultrasound guidance and we have had no cases of bowel injury in our group. If bowel is completely covering the bladder we have pioneered a technique to displace the bowel using injection of water (hydrodissection) and have successfully achieve suprapubic catheter insertion in the number of these cases.
HOW IS A SUPRAPUBIC CATHETER INSERTED?
Following a thorough consent process and completion of the safety checklist, local anaesthetic is injected into the bladder via the existing urethral catheter (if one is in place) to anaesthetise the lining of the bladder. The skin of the lower abdomen and pelvis is then cleaned and further local anaesthetic injected into the skin and down to the bladder edge.  A needle is then inserted into the bladder through which a wire is passed. Over this wire a plastic tube (sheath) is placed which allows the catheter to be inserted into the bladder. The tip of the catheter has a balloon which is inflated with water to retain the catheter in place. Once confirmed in position, a dressing is applied and any pre-existing urethral catheter is usually removed.
WHAT ARE THE ALTERNATIVES TO A SUPRAPUBIC CATHETER?
• Urethral catheter – usually a permanent catheter passed through your urethra into your bladder. Some patients intermittently self-catheterise by passing a disposable catheter into their bladder several times a day.
• Condom drainage device – a rubber sheath which sits on the penis and is attached to a catheter drainage bag.
• Incontinence pads
• Surgery – either a urostomy to divert your urine onto the surface of your abdomen, or other diversion techniques.
HOW PAINFUL IS A SUPRAPUBIC ACTHETER INSERTION UNDER LOCAL ANASTHETIC?
Generally well tolerated. We inject local anaesthetic into the bladder via any existing urethral catheter to reduce the sensitivity of the bladder 10 minutes prior to the procedure. We also anaesthetise the skin and entire catheter track between the skin an bladder. As a result the procedure is reasonably well tolerated. For many patients there is minimal discomfort, although for others pain scores can reach 5 or 6 out of 10 for the most painful part of the procedure which lasts approximately 60 seconds. Occasionally, if a bladder is very contracted and uncomfortable, we use an sedation but generally this is not necessary.
HOIW LONG DOES THE PROCEDURE TAKE
The procedure itself takes approximately 20-30 minutes. Patient preparation and recovery mean the entire attendance is 2-3 hours.
WHAT HAPPENS AFTER THE PROCEDURE
We will usually remove your existing urethral catheter once the suprapubic catheter is in place. We will monitor you for 1 hour following the procedure before letting you go home.
WHERE CAN I GET MORE INFORMATION?
https://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Suprapubic.pdf
https://www.bladderandbowel.org/surgical-treatment/suprapubic-catheter/