The principal advantages of suprapubic drainage of the bladder compared with the transurethral indwelling catheter are to be seen in holding back ascending infection of the urinary tract and avoidance of urethral trauma. In addition to relieving the bladder in subvesical obstructions the most important indication in practise is continuous drainage of urine in patients in intensive care. With strict observation of puncture technique and contraindications (contracted bladder, tumors in the lower abdomen, bladder carcinoma, macrohematuria and hemorrhagic diathesis) the entire complication rate is 4.3% (2.3% macrohematuria, 1.5% local infection, 0.5% peritoneal lesion). With the introduction of the disposable puncture systems the suprapubic bladder fistula has become a superior alternative to the indwelling catheter in many cases.
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