Retrospective Evaluation of Contemporary Complication Rates and Severity After Suprapubic Tube Placement by Urology and Interventional Radiology

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INTRODUCTION: To compare complication rates and severity associated with suprapubic tube (SPT) placement by urology versus interventional radiology (IR) and to identify patient factors associated with increased complication risk. METHODS: A retrospective, single-center review from 2017 to 2022 examined patients who underwent SPT placement by urology or IR. Patients without 90-day follow-up were excluded. Patient demographics, indications for SPT placement, and perioperative, 30- and 90-day postoperative complications were recorded using the Clavien-Dindo (CD) classification system. Outcomes were compared between urology and IR. Multivariable logistic regression assessed associations between preoperative factors, specialty and major complications. RESULTS: A total of 266 patients were included (179 urology, 87 IR). Median age was 68 years; 64% were male, and 56% had neurogenic bladder. Median catheter size was 18 Fr and 20 Fr for urology and IR, respectively (p = 0.05). Perioperative complication rates were low and comparable (5.6% urology vs. 5.8% IR, p = 0.80). Most 30- and 90-day complications were minor (CD grades 1-2), primarily urinary tract infections and SPT malfunction, while major complications (CD grades 3-5) were uncommon. Overall, 90-day complication rates were similar (48% urology vs. 45% IR, p = 0.66), though major complications occurred more frequently in the IR group (11% vs. 5.2%, p = 0.04). On multivariable analysis, specialty, history of pelvic radiation, and prior pelvic surgery were not significantly associated with severe complications. CONCLUSION: Urology and IR have comparable, low complication rates for SPT placement. Perioperative complications are infrequent and more severe. Longer-term complications were common but more likely to be minor, primarily urinary tract infections or SPT dislodgement with higher rates of urinary tract infections in SPTs placed by IR.

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