eMedicine Specialties > Clinical Procedures > Genitourinary Procedures
Suprapubic Aspiration
Updated: Apr 5, 2009
Introduction
Suprapubic aspiration and catheterization is a procedure to obtain uncontaminated bladder urine.1 It is easy to perform in the emergency department and is associated with minimal complications. Huze and Beeson first published this practice in 1956 as an alternative to more traditional methods of obtaining urine for analysis and culture.2 Their findings suggested that suprapubic catheterization and aspiration was superior to clean-catch or transurethral (via catheterization) collection of bladder urine for bacteriologic study. The sensitivity of the aspirated urine for bacteriuria on urinalysis approaches 100% and is rarely associated with contamination.3
Indications
- Urinary retention (eg, prostate hypertrophy or cancer, gynecologic malignancy, spinal cord injury)4
- Urinalysis or urine culture in neonates or children younger than 2 years5
- Phimosis
- Chronic infection of the urethra or periurethral glands
- Urethral stricture6
- Urethral trauma7
Contraindications
- Empty or unidentifiable bladder (eg, child’s last urination within 1 hr, nonpalpable bladder in adults)
- Known bladder tumor
- Lower abdominal wounds or scarring
- Overlying cellulitis
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References
Stine RJ, Avila JA, Lemons MF, et al. Diagnostic and therapeutic urologic procedures. Emerg Med Clin North Am. Aug 1988;6(3):547-78. [Medline].
Beeson PB, Guze LB. Observations on the reliability and safety of bladder catheterization for bacteriologic study of the urine. N Engl J Med. Sep 6 1956;255(10):474-5. [Medline].
Hardy JD, Furnell PM, Brumfitt W. Comparison of sterile bag, clean catch and suprapubic aspiration in the diagnosis of urinary infection in early childhood. Br J Urol. Aug 1976;48(4):279-83. [Medline].
Selius BA, Subedi R. Urinary retention in adults: diagnosis and initial management. Am Fam Physician. Mar 1 2008;77(5):643-50. [Medline].
Sastre JB, Aparicio AR, Cotallo GD, Colomer BF, Hernández MC. Urinary tract infection in the newborn: clinical and radio imaging studies. Pediatr Nephrol. Oct 2007;22(10):1735-41. [Medline].
Villanueva C, Hemstreet GP 3rd. Difficult male urethral catheterization: a review of different approaches. Int Braz J Urol. Jul-Aug 2008;34(4):401-11; discussion 412. [Medline].
Robinson J. Insertion, care and management of suprapubic catheters. Nurs Stand. Oct 29-Nov 4 2008;23(8):49-56; quiz 58. [Medline].
Gochman RF, Karasic RB, Heller MB. Use of portable ultrasound to assist urine collection by suprapubic aspiration. Ann Emerg Med. Jun 1991;20(6):631-5. [Medline].
Noller KL, Pratt JH, Symmonds RE. Bowel perforation with suprapubic cystostomy Report of two cases. Obstet Gynecol. Jul 1976;48(1 Suppl):67S-69S. [Medline].
O'Brien WM. Percutaneous placement of a suprapubic tube with peel away sheath introducer. J Urol. May 1991;145(5):1015-6. [Medline].
Promes SB. Miscellaneous Applications. In: Simon BC, Snoey ER. Ultrasound in Emergency and Ambulatory Medicine. St. Louis, MO: Mosby, Inc; 1997:256-261.
Schneider RE. Urologic Procedures. In: Robert JR, Hedges JR. Clinical Procedures in Emergency Medicine. 6(3). 4th ed. Philadelphia, PA: W.B. Saunders Co; 2004:1098-1100.
Moustaki M, Stefos E, Malliou C, Fretzayas A. Complications of suprapubic aspiration in transiently neutropenic children. Pediatr Emerg Care. Nov 2007;23(11):823-5. [Medline].
Vilke GM. Bladder Aspiration. Rosen P. Atlas of Emergency Procedures. St. Louis, MO: Mosby, Inc; 2001:130-131.
Further Reading
eMedicine from WebMD: Urinary Tract Infection, Males
eMedicine from WebMD: Urinary Tract Infection, Female
Keywords
suprapubic aspiration, urinary tract infection, pediatric fever workup, urine culture, urethral trauma, spinal cord injury, urinary retention, bladder catheterization, urethral catheterization in men, urethral catheterization in women, urine aspiration, suprapubic catheterization, ED urine collection, urine analysis, urine collection, bedside ultrasonography, cystostomy, indwelling catheter, Foley catheter, suprapubic catheter
Overview: Suprapubic Aspiration