Trans-Urethral Supra-Pubic Tube Guide
Surgical Technique for ColMed TUSPTM
- Select an appropriate sterile catheter (<21 Fr), lubricate, and confirm fit inside the TUSP cannula. Lubricate and screw the trocar tip into the distal end of the cannula until flush—it is secure with minimum finger tightening.
- Place the patient in lithotomy position and prep with appropriate sterilizing solution. Perform cystoscopy to survey the anatomy of the urethra and bladder. If there is risk of urethral trauma, consider pre-placement of a guide wire (<0.038 in). Determine the optimal location for the trocar to exit the abdominal wall, and mark.
- Place the TUSP retrograde through the urethra, into the bladder. For a male, place penis on stretch. While gently angulating the handle, palpate for the tip of the device near the exit mark,
- Make an incision in the skin approximate 1 cm above the tip. While maintaining deflection on the abdominal wall with the TUSP, dissect the intervening tissue with electro-cautery until trocar emerges from the incision. Continue to push the trocar through incision about 5 cm. Remove the trocar tip and leave the cannula above the incision a few cm.
- Guide the lubricated catheter into the cannula about 25 cm (10 in) until it appears at the handle opening. If catheter buckles while advancing, push on it closer to the entry of the cannula.
- While holding the catheter at incision site, slowly withdrawal the TUSP from the urethra. Then using cystoscopic guidance retrograde through urethra, withdraw the catheter tip retrograde into the bladder by pulling externally above the incision site.
- Once the catheter is within the bladder lumen, inflate the balloon to recommended volume. Then gently approximate the balloon against the anterior bladder wall. Secure the catheter externally with a suture.