eMedicine Specialties > Clinical Procedures > Genitourinary Procedures

Suprapubic Aspiration

Author: Adam J Rosh, MD, MS, Assistant Professor, Department of Emergency Medicine, Wayne State University/Detroit Receiving Hospital
Contributor Information and Disclosures

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

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

More on Suprapubic Aspiration

Overview: Suprapubic Aspiration
Treatment & Medication: Suprapubic Aspiration
Multimedia: Suprapubic Aspiration
References
Further Reading

References

  1. 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].

  2. 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].

  3. 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].

  4. Selius BA, Subedi R. Urinary retention in adults: diagnosis and initial management. Am Fam Physician. Mar 1 2008;77(5):643-50. [Medline].

  5. 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].

  6. 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].

  7. Robinson J. Insertion, care and management of suprapubic catheters. Nurs Stand. Oct 29-Nov 4 2008;23(8):49-56; quiz 58. [Medline].

  8. 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].

  9. 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].

  10. O'Brien WM. Percutaneous placement of a suprapubic tube with peel away sheath introducer. J Urol. May 1991;145(5):1015-6. [Medline].

  11. Promes SB. Miscellaneous Applications. In: Simon BC, Snoey ER. Ultrasound in Emergency and Ambulatory Medicine. St. Louis, MO: Mosby, Inc; 1997:256-261.

  12. 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.

  13. 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].

  14. 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

Contributor Information and Disclosures

Author

Adam J Rosh, MD, MS, Assistant Professor, Department of Emergency Medicine, Wayne State University/Detroit Receiving Hospital
Adam J Rosh, MD, MS is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

Andrew K Chang, MD, Associate Professor, Department of Emergency Medicine, Albert Einstein College of Medicine, Montefiore Medical Center
Andrew K Chang, MD is a member of the following medical societies: American Academy of Emergency Medicine, American Academy of Neurology, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Luis M Lovato, MD, Associate Clinical Professor, David Geffen School of Medicine at UCLA; Director of Critical Care, Department of Emergency Medicine, Olive View/UCLA Medical Center
Luis M Lovato, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

Gil Z Shlamovitz, MD, Assistant Professor of Emergency Medicine, University of Connecticut School of Medicine; Attending Physician, Emergency Department, Windham Community Memorial Hospital, Willimantic, CT; Attending Physician, Emergency Department, Hartford Hospital, Hartford, CT
Gil Z Shlamovitz, MD is a member of the following medical societies: American Academy of Emergency Medicine and American College of Emergency Physicians
Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD, Medical Director, Assistant Professor of Surgery, Section of Emergency Medicine, Yale-New Haven Hospital
Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: WebMD Salary Employment

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