Epicystostomy

Epicystostomy

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Epicystostomy, also known as suprapubic cystostomy, is a surgical procedure in which a catheter is inserted directly into the urinary bladder through an incision in the lower abdominal wall. This procedure is typically performed when there is an obstruction or other condition that prevents the normal passage of urine through the urethra.

Purpose and Indications

The primary purpose of an epicystostomy is to provide an alternative route for urine drainage when the normal urinary pathway is blocked or compromised. It is commonly indicated in the following situations:

• Urethral obstruction caused by conditions such as prostate enlargement, urethral strictures, or cancer
• Neurogenic bladder dysfunction, where the bladder cannot empty properly due to nerve damage or spinal cord injury
• Bladder outlet obstruction caused by pelvic organ prolapse or other pelvic disorders
• Severe bladder trauma or injury that prevents normal urination

Procedural Steps

The epicystostomy procedure typically involves the following steps:

1. Administration of anesthesia (general or local)
2. Making a small incision in the lower abdomen, just above the pubic bone
3. Identifying and accessing the bladder
4. Inserting a catheter through the incision into the bladder
5. Securing the catheter in place
6. Closing the incision around the catheter

After the procedure, the catheter remains in place, allowing urine to drain from the bladder into a collection bag.

The epicystostomy catheter may be temporary or permanent, depending on the underlying condition and the patient's needs. Regular maintenance and care are essential to prevent complications such as infections or catheter blockages.

The Role of Epicystostomy

Epicystostomy is a surgical procedure that involves creating an opening in the bladder through the abdominal wall. It is primarily used as a temporary measure to provide urinary diversion and drainage when normal urinary function is impaired or obstructed. Epicystostomy plays a crucial role in managing various urological conditions and complications.

Indications for Epicystostomy

Epicystostomy may be recommended in several circumstances, including:

• Bladder outlet obstruction: Conditions such as advanced prostate cancer, pelvic masses, or injuries that obstruct the normal flow of urine from the bladder may necessitate an epicystostomy to allow for urinary drainage.
• Neurogenic bladder dysfunction: In cases where the bladder lacks normal neural control, such as spinal cord injuries or neurological disorders, an epicystostomy can provide a means for catheterization and bladder management.
• Urinary tract trauma: Severe injuries to the urethra, bladder, or pelvic region that disrupt normal urinary flow may require an epicystostomy as a temporary solution.
• Palliative care: In certain terminal conditions, an epicystostomy may be performed to alleviate discomfort and improve quality of life by facilitating urinary drainage.

Preparation for Epicystostomy Procedure

Before undergoing an epicystostomy procedure, certain preparations are recommended:

• Maintain a normal diet: No specific dietary restrictions are typically required for an epicystostomy. However, it is advisable to maintain a balanced and healthy diet.
• Inform your doctor about medications: Provide your healthcare provider with a list of all medications, supplements, and herbal remedies you are currently taking, as some may interact with the procedure or anesthesia.
• Discontinue blood-thinning medications: Your doctor may advise you to temporarily stop taking certain blood-thinning medications, such as aspirin or warfarin, to reduce the risk of excessive bleeding during the procedure.
• Ensure proper hydration: Drink plenty of fluids before the procedure to maintain proper hydration, which can facilitate the procedure and aid in recovery.
• Arrange for transportation: Plan for someone to drive you home after the procedure, as you may experience side effects from anesthesia or sedation.

Epicystostomy Procedure

The epicystostomy procedure involves the surgical creation of a temporary opening (stoma) in the bladder to allow for the drainage of urine. It is typically performed under local or general anesthesia. The specific steps of the procedure may vary depending on the patient's condition and the surgeon's technique.

Procedure and Purpose

Epicystostomy can be performed as an open surgical procedure or as a minimally invasive, percutaneous technique. The procedure is commonly performed in cases where patients are unable to pass urine through the normal urinary tract, such as in cases of urethral obstruction, neurogenic bladder dysfunction, or pelvic malignancies. It allows for bladder drainage and decompression, relieving symptoms and potential complications associated with urinary retention.

Sources:

https://emedicine.medscape.com/article/1893882-technique
https://en.wikipedia.org/wiki/Suprapubic_cystostomy
https://emedicine.medscape.com/article/1893882-overview
https://www.urotoday.com/library-resources/suprapubic-catheter/144206-procedure-for-changing-a-suprapubic-catheter-spc-or-spt.html
https://my.clevelandclinic.org/health/treatments/25028-suprapubic-catheter
https://www.drugs.com/cg/suprapubic-cystostomy.html

IMPORTANT!

It is crucial to remember that the information provided in this section is not intended for self-diagnosis or self-treatment. If you experience any pain or exacerbation of a condition, it is essential to consult a qualified medical professional for appropriate diagnostic tests and treatment. Only a qualified specialist can provide an accurate diagnosis and determine the appropriate course of treatment. To ensure the most accurate and consistent evaluation of test results, it is recommended to have them performed at the same laboratory. Different laboratories may use varying methods and units of measurement for similar tests.