Selected topics: emergency radiologyUltrasound-guided suprapubic cystostomy catheter placement in the emergency department
Introduction
Ultrasound scanning has been described as useful in facilitating many procedures in the Emergency Department (ED): cardiac pacemaker placement, central venous catheter placement, pericardiocentesis, thoracentesis, foreign body removal, and bladder aspiration 1, 2. It is the general consensus that ultrasound provides additional safety and efficacy by providing real-time imaging that is superior to blind approaches. Although ultrasound-guided bladder aspiration has been described in the literature, we describe a consecutive series of ultrasound technology used in conjunction with emergency bladder drainage in the context of a suprapubic catheter placement guided by ultrasound (3).
Section snippets
Methods
A prospective case series was conducted to assess the safety and efficacy of ultrasound-guided suprapubic cystostomy catheter placement in the ED. We subsequently describe a consecutive series of patients who underwent real-time ultrasound-guided procedures over a 2-year period. The trial was conducted in a large urban university-affiliated ED with an annual census of 65,000 patients. Patients were eligible for enrollment if they were at least 18 years of age, had at least three attempts of
Results
Of the 17 patients enrolled, all were men with ages ranging from 36 to 92 years (median age of 60.7). Ultrasound imaging accurately detected the presence of a dilatated bladder in each case. Ultrasound-guided suprapubic cystostomy placement was successfully performed in every patient studied without reports of complications. Acute urinary retention requiring acute decompression by way of an emergency suprapubic cystostomy occurred due to prostatic hypertrophy in 10 patients, strictures and
Discussion
Urethral catheterization is the most frequent urological procedure performed in the ED. Emergency Physicians are frequently faced with the need to evaluate and treat patients with acute urinary retention requiring bladder drainage. A certain number of these patients will require emergency bladder decompression by suprapubic cystostomy. Although ultrasonography has been reported to facilitate needle aspiration of the bladder in children, no studies have been conducted on its potential use for
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