Suprapubic bladder drainage in elective colorectal surgery

Suprapubic bladder drainage was assessed in 399 patients, following surgery of the rectum and sigmoid colon. An Argyle-Ingram catheter no. 16 French was inserted after the laparotomy incision had been made. The bladder was drained continuously for 24 hours, after which the catheter was closed and reopened every 6 hours for 10 minutes. The catheter was removed when the postvoided volume became less than 50 ml on each of two subsequent measurements. Abdominoperineal excision required the longest drainage period. Urethral catheterization became necessary in 13 men and six women because of persistent or recurrent urinary retention. Failures of suprapubic drainage made urethral catheterization necessary in 17 of 31 patients. Uroperitoneum, due to leakage from the bladder after removal of the suprapubic catheter, was seen in one patient with infravesical obstruction and bladder diverticula. The patient recovered after relaparotomy and suture of the bladder. Suprapubic drainage is recommended because it permits spontaneous voiding. Urethral instrumentation is avoided in most cases. Residual volume can be measured without urethral catheterization. Complications are few, and discomfort to the patient is seen in no more than 1 percent.