Suprapubic aspiration

Medical procedure to obtain urine directly from the bladder

Suprapubic aspiration is a medical procedure used to obtain a sterile urine sample directly from the urinary bladder. This technique is particularly useful in certain clinical situations where contamination of the urine sample is a concern, or when other methods of urine collection are not feasible.

Procedure

Position of the urinary bladder

The procedure involves the insertion of a needle through the abdominal wall into the bladder. The patient is typically placed in a supine position, and the area above the pubic bone is cleaned with an antiseptic solution. Local anesthesia may be administered to minimize discomfort. Using ultrasound guidance can increase the accuracy of needle placement, especially in patients with a distended bladder.

Once the needle is inserted into the bladder, urine is aspirated into a syringe. The sample is then sent for laboratory analysis. This method is considered to provide a sterile sample, as it bypasses the urethra, which can be a source of contamination.

Indications

Suprapubic aspiration is indicated in several clinical scenarios:

• When a sterile urine sample is required for accurate diagnosis of urinary tract infections (UTIs), especially in infants and young children.
• In patients with urinary retention where catheterization is not possible or contraindicated.
• When there is a need to obtain a urine sample in patients with neurogenic bladder or other conditions that prevent normal voiding.

Contraindications

The procedure is contraindicated in patients with:

• Coagulopathy or bleeding disorders, due to the risk of bleeding.
• Abdominal wall infection at the site of needle insertion.
• An empty bladder, as this increases the risk of injury to surrounding structures.

Complications

While generally safe, suprapubic aspiration can have complications, including:

• Hematuria, or blood in the urine, due to trauma to the bladder wall.
• Infection at the puncture site.
• Injury to surrounding organs, such as the intestines, especially if the bladder is not adequately distended.

Advantages

The primary advantage of suprapubic aspiration is the ability to obtain a truly sterile urine sample, which is crucial for accurate diagnosis and treatment of UTIs. It is also a valuable technique in patients where other methods of urine collection are not possible.

Related pages

• Urinary catheterization
• Urinary tract infection
• Bladder
• Ultrasound