Long-term bladder drainage: Suprapubic catheter versus other methods: a scoping review.

Aims: The purpose of this scoping review was to examine research activity comparing suprapubic catheterization to any other method of chronic bladder emptying such as intermittent and indwelling catheterization in adults in relation to complications, patient satisfaction, and health-related quality of life (QoL).

Methods: A search of electronic databases (MEDLINE, CINAHL, SCOPUS, and OVID) was performed 1950-May 2012 using the search terms, singly or combined: suprapubic, catheter, long term, effectiveness, urinary, health promotion, incontinence, retention, QoL, and evidence based. All research designs were included. Papers were excluded if catheter duration was <30 days or were single case reports.

Results: Twenty-six articles were identified for potential inclusion from an initial 394 and 14 retained after final review. Studies varied in subjects, outcome measures, and publication dates. The majority were retrospective reviews; four were descriptive/qualitative studies. Based on the clinical findings, suprapubic catheters are associated with a low incidence of urethral injury and stricture, but have similar rates of upper tract damage, vesicoureteral reflux, renal or bladder calculi, and symptomatic urinary tract infections compared to urethral catheters. Users report being generally satisfied with suprapubic catheters. No studies addressed stoma or skin care, urethral leakage, or adherence to the suprapubic catheter after insertion.

Conclusion: Most studies focused on clinical urologic issues rather than patient understanding of suprapubic catheter management, satisfaction, stoma and skin care, or health related QoL. Further studies are needed to elucidate efficacy from an individual user and clinician perspective.