Imaging-guided Percutaneous Large-Bore Suprapubic Cystostomy, a Safe Bladder Diversion Alternative

Suprapubic catheter placement is a common method of bladder diversion. To date, there are limited reports describing safe placement of large-bore (18–28 F) catheters as smaller catheters often clog and require upsizing procedures. We retrospectively evaluate the image-guided percutaneous placement of large-bore catheters by interventional radiologists in our institution, totaling 51 catheters in 51 patients over 5 years. We successfully placed a large-bore catheter in 96% (49/51) of first attempts with no post-procedural complications. This data demonstrates that percutaneous placement of large-bore suprapubic catheters by interventional radiologists is a safe and less-invasive bladder diversion alternative to traditional blind or open surgical techniques.