Suprapubic Cystostomy And Catheter Insertion

What you should know

  • Suprapubic cystostomy is surgery to create a stoma (opening) through the abdomen and into the urinary bladder. This opening is where a catheter is inserted to drain urine. Urine is excreted from the kidneys and passes through the ureters. It is stored for a short time in the bladder before it exits through the urethra. If urine is not drained, it may lead to urinary tract infections and other problems. Cystostomy surgery may be done because the flow of urine is blocked. It may be needed for men who have a swollen or injured prostate gland. It may also be needed for people who have an injury to the urinary tract and other conditions.

  • Before the surgery, you may need to drink more fluids to fill your bladder with urine. A stoma is created by making an incision (cut) on your abdomen. Another incision is made on your bladder. A catheter (thin rubber tube) is inserted through these incisions. The continuous opening through which the catheter is inserted is made to heal for long term use of a catheter. Having a suprapubic cystostomy done and catheter inserted may help drain your urine properly and relieve symptoms of urinary retention or blockage.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.


  • Suprapubic cystostomy surgery has some risks. You may get an infection or bleed more than expected. You may get blood clots or have trouble breathing. Caregivers will watch you closely for these problems. Your internal organs or blood vessels may be damaged during surgery. Having a suprapubic catheter may cause urinary tract infections and bladder irritation. Long term use can also lead to formation of kidney stones, blood in the urine, and swelling of the bladder. Catheters used over a period of time can also develop problems which make them very hard to remove and replace.

  • If you do not have the surgery, symptoms of urinary retention may become even worse. The symptoms of urinary retention or obstruction will be relieved by having suprapubic cystostomy and catheter insertion. The condition causing the symptoms may need further treatment. Talk to your caregiver if you are worried about these risks and for information about further treatment that might be needed.

Getting Ready

The week before your surgery:

  • Ask a family member or friend to drive you home after your surgery. Do not drive yourself home.

  • Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.

  • If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your procedure. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before the procedure. You may need to check your blood sugar more often before and after having your procedure.

  • If you are a female, tell your caregiver if you know or think that you might be pregnant.

  • Tell your caregiver if you have had a previous procedure or surgery done on your abdomen. Tell him if you have bleeding problems or are taking medicines like blood thinners.

  • You may need to have some other tests done before the surgery. Pictures may be taken using an ultrasound to find the position of your bladder. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The day of your surgery:

  • Write down the correct date, time, and location of your surgery.

  • Ask caregivers about directions for eating and drinking.

  • What to bring: You may want to bring items such as a toothbrush and bathrobe.

  • Ask your caregiver before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.

  • If you wear contact lenses, do not wear them on the day of your procedure or surgery. Glasses may be worn.

  • Do not wear tight-fitting clothes on the day of your procedure or surgery.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.


What will happen:

  • You will be asked to change into a hospital gown. You will be brought on a stretcher to the operating room. You may be given a local or general anesthesia to control the pain during the surgery. A caregiver will clean your stomach area and clean sheets will be put on you.

  • A small incision will be made on your abdomen below your belly button. A caregiver may use a syringe with a needle to get urine directly from your full bladder. This is done to find and identify the bladder. Special devices, such as urethral sounds and retrograde bougies, may be used to prevent damage to nearby organs. Another small incision will be made on the bladder where the catheter will be inserted. Once the catheter is in place, the balloon on the end of the catheter will be filled with sterile water. This balloon keeps the catheter in place inside the bladder. The other end of the catheter will be connected to a clean drainage bag, or closed with a valve. The catheter may be secured in the stoma with sutures (threads) or surgical tape.

After your surgery:

  • You will be taken to a room where you can rest. Caregivers will check on you. When they see that you are ready, you may be able to go home. If you are staying in the hospital, you will be taken to your hospital room. Do not get out of bed until your caregiver says it is OK. A bandage is placed around your stoma to keep the area clean and dry to help prevent infection. A caregiver may remove the bandage soon after your surgery to check the stoma.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

  • You cannot make it to your appointment on time.

  • You have a fever.

  • You have a skin infection or an infected wound near the area where the cystostomy surgery will be done.

  • You have questions or concerns about your surgery.

Seek Care Immediately if

  • The problems for which you are having the surgery get worse.

  • You have problems and more pain when passing urine.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.