Going with the flow: a comparative analysis of suprapubic catheter insertion rates in Australia

Background Voiding trials are routine following female pelvic floor surgery to ensure bladder voiding function is adequate with acceptable residual volume. The most common method is with use of an indwelling Foley catheter. Suprapubic catheters are another option, but are less popular. Aims The aim was to ascertain the uptake of suprapubic catheters for voiding trials in Australia, and to examine any significant differences in uptake over time or across geographical regions. Methods Data for suprapubic stab cystotomy procedures performed in Australia was captured via the Medicare Benefits Schedule to determine the rate of the procedure per 100,000 of the female population. Gender and state specific data were obtained from January 2004 to December 2023. Analysis was carried out using simple descriptive and comparative statistics. Results Results show that the total number of suprapubic catheter insertions in Australia declined from 21 to 6 per 100,000 population between 2004 and 2023, a 71.4% decline. In the most recent data set (2023) New South Wales (also the most populous state) had the highest rate of insertion at 11 per 100,000 population and Northern Territory the lowest at 0 per 100,000 population. Victoria, the second most populous state, had a rate of 2 per 100,000 population in 2023. In contrast to the other states, Queensland saw an increase of 20% over the same time period. Conclusions Based on these results, we concluded that rates of suprapubic catheter insertions in Australia are declining. Possibilities for causes of this decline include a lack of training, preconceptions around risks of the procedure and case mix of clinicians.