urethral versus suprapubic catheterisation

Last reviewed 01/2018

Suprapubic catheterisation has the following advantages:

• less uncomfortable for the patient once complete
• cleaner
• easier to perform a trial without catheter; the suprapubic is simply spiggoted and unspiggoted if the trial fails
• particularly indicated if there is a history of surgery to the urethra, or if there is a known urethral stricture

Problems with suprapubic catheterisation include:

• previous lower abdominal surgery may cause difficulty, especially if there has been peritonitis after bowel perforation
• the midline should be avoided by 1 cm, and the catheter placed 2 cm above the symphisis pubis
• there must be bladder distension to allow palpation and accurate placement