Suprapubic catheter placement is not without risks for both the patient and the user - when done inappropriately the cannula may perforate the bowel, or cut the operator's gloves and fingers. Moreover, the catheter itself may also be damaged during placement. Taking these risks into account, it is common practice to call the most skilled urologist and ask them to do the job.
The metal splittable cannula has so far been the most popular suprapubic catheter placement tool, but at some point you need to split it and you end up with a very long and sharp piece of metal. This clearly conveys a risk, particularly when there is an element of time pressure present.
In addition, the splittable metal cannula was not designed to fit into the guide of an ultrasound probe, making it complicated for it to benefit from ultrasound guidance.
A solution exists - the Cystofix SG puncture sets use the standardised and safe Seldinger placement technique, with ultrasound guidance, and comes in a complete set. The Seldinger technique is well known by urologists who use it during percutaneous nephrostomy (PCN), and by emergency specialists who use it for central venous catheters (CVCs).
There is no more splittable metal cannula, but instead a long 18G needle, a guide wire and a dilator. The 18G needle fits into the guide of an ultrasound probe and allows the user to benefit from the ultrasound guidance. This allows direct visual control of the puncture track in order to avoid bowel loops.
