Suprapubic bladder aspiration: Difference between revisions
Neil.m.young (talk | contribs) No edit summary |
ClaireLewis (talk | contribs) No edit summary |
||
| (5 intermediate revisions by 3 users not shown) | |||
| Line 1: | Line 1: | ||
==Indications== | ==Indications== | ||
*Urine for bacteriology in children < 2 | *Urine for [[UTI (peds)|bacteriology]] in children < 2 | ||
*Phimosis | *[[Phimosis]] | ||
*Urinary retention | *[[Urinary retention]] | ||
*Urethral trauma/stricture | *[[Urethral trauma]]/stricture | ||
*Chronic urethral or periurethral infection | *Chronic urethral or periurethral infection | ||
| Line 24: | Line 24: | ||
#Locate the full and distended bladder with ultrasound and palpation | #Locate the full and distended bladder with ultrasound and palpation | ||
#Prep skin | #Prep skin | ||
#Place lidocaine wheal at point of planned entry (usually midline | #Place lidocaine wheal at point of planned entry (usually midline 2-4cm above superior edge of pubic symphisis), aim caudad, 60 degrees from horizontal plane of abdomen | ||
#In infants, insert and appropriate length 22G needle 10-20 degrees cephalad from perpendicular and aspirate until urine returns | #In infants, insert and appropriate length 22G needle 10-20 degrees cephalad from perpendicular and aspirate until urine returns | ||
#*Remember, the bladder is an abdominal organ in newborns. | #*Remember, the bladder is an abdominal organ in newborns. | ||
#*Be prepared for a spontaneous void during stimulation of bladder | #*Be prepared for a spontaneous void during stimulation of bladder | ||
#If no urine is obtained, withdraw to subQ tissue and redirect | #If no urine is obtained, withdraw to subQ tissue and redirect | ||
#In adults, insert a longer 22G needle 10-20 degrees caudad from true | #In adults, insert a longer 22G needle 10-20 degrees caudad from true vertical and aspirate after the skin is entered | ||
==Complications== | ==Complications== | ||
| Line 38: | Line 38: | ||
==See Also== | ==See Also== | ||
*[[Urinary retention]] | *[[Urinary retention]] | ||
*[[Suprapubic catheter placement]] | |||
*[[Suprapubic catheter changing or replacement]] | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Procedures]] | [[Category:Procedures]] | ||
[[Category:Urology]] | |||
Latest revision as of 15:40, 10 October 2019
Indications
- Urine for bacteriology in children < 2
- Phimosis
- Urinary retention
- Urethral trauma/stricture
- Chronic urethral or periurethral infection
Contraindications
- Empty or unidentifiable bladder
- Known bladder tumor
- Lower abdominal wounds
- Overlying cellulitis
Equipment
- Sterile gloves
- Skin prep
- Lidocaine
- Sterile syringe, 10 or 20 mL
- Needle, 22 gauge (ga), 1.5 in, for pediatric patients
- Spinal needle, 22 ga, for adult patients
- Dressing
Procedure
- Locate the full and distended bladder with ultrasound and palpation
- Prep skin
- Place lidocaine wheal at point of planned entry (usually midline 2-4cm above superior edge of pubic symphisis), aim caudad, 60 degrees from horizontal plane of abdomen
- In infants, insert and appropriate length 22G needle 10-20 degrees cephalad from perpendicular and aspirate until urine returns
- Remember, the bladder is an abdominal organ in newborns.
- Be prepared for a spontaneous void during stimulation of bladder
- If no urine is obtained, withdraw to subQ tissue and redirect
- In adults, insert a longer 22G needle 10-20 degrees caudad from true vertical and aspirate after the skin is entered
Complications
- Inability to aspirate urine
- Hematuria (microscopic is common, gross is uncommon)
- Penetration of bowel (innocuous if entered with small needle only)