Suprapubic Tubes aka "Super Pubic"

Overview of the "Super Pubic" suprapubic (superior to the pubic bone) approach:

A suprapubic tube may be used for urinary retention (unable to void) or incontinence (lack of voluntary control over urination) as an alternative to an indwelling urethral "Foley" catheter or intermittent "straight" catheter (performed several times a day) to empty urine from the bladder.

A suprapubic catheter tube can be inserted as a temporary or permanent measure in patients with urinary dysfunction or if initial urethral catheter insertion or re-catheterization is problematic.

A few of the benefits achieved with suprapubic bladder drainage:

• Dramatically lower Urinary Tract Infection (UTI) rate
• Improved Quality-of-Life
• Provides freedom, independence, and better sleep cycles
• Less pain — more comfortable than urethral catheters
• Eliminates urethral injuries and complications from urethral catheters
• Easily reversible when no longer required
• Proven to provide many benefits not available with urethral catheters
  (see Bladder Catheter Options Comparison Chart)

 

There are three techniques for placing a suprapubic tube, all require a surgical procedure:

• Open cystostomy
• Highly invasive surgical technique ~ large incision
• Requires hospital stay for post-op recovery
  
• Procedure time: up to 2 hours under general anesthesia 
• Percutaneous Trocar Punch 
• Minimally invasive technique - dilated tract over small needle incision or core hole punch
• Outside-to-in blind puncture approach
  
• Procedure time: 10 to 15 minutes under local or general anesthesia
• T-SPeC 
• Minimally invasive technique ~ small 5mm linear incision
• Inside-to-out controlled placement approach
• Procedure time: 5 minutes under local or general anesthesia

 

Suprapubic Clinical Procedure Outcomes

Open Cystostomy	Percutaneous Trocar Punch	T-SPeC
Highly Invasive	Minimally Invasive	Minimally Invasive
1-2 Hour Procedure	15 Minute Procedure	5 Minute Procedure
Long Recovery w/Post-Op Hospitalization	Small Catheter Size (unreliable drainage)	Large Drainage Tube (18 Fr)
Large Open Incision	Unpredictable Surgical Tract	Small/Accurate Surgical Tract
High Complication Rate – 30.3% 46	Low Complication Rate – 45.5% 45	Low Complication Rate – 3.5% 44
High Mortality Rate –  1.83% 46	High Mortality Rate – 4.4% 47	No Mortality – 0%* 44

* Statistics as of the publication date 2/10/2018

 

ATTENTION: Some physicians/hospitals still use the device listed below:

• Lowsely Tractor (manufacturer no longer makes or supports this device)
• Minimally invasive technique ~ large incision
• Inside-to-out placement approach
• No reconditioning (maintenance) process supported by manufacturer
  FDA Reconditioning Requirement
• No FDA sterilization (cleaning) validation for a reusable device 
  FDA Reprocessing Requirements
• Numerous FDA reported device failures (MAUDE)
  FDA Reported Device Failures

 

Physicians prefer the safety, efficiency, and outcomes with the placement technique achieved with T-SPeC: