Real-World Short-Term Safety of Ultrasound-Guided Suprapubic Trocar Catheter Placement in Neurogenic Lower Urinary Tract Dysfunction: A Retrospective Cohort Study

Objective: To determine the incidence of severe 30-day complications (Clavien–Dindo ≥ III) after ultrasound-guided percutaneous suprapubic catheter placement in patients with neurogenic lower urinary tract dysfunction and to describe overall 30-day safety outcomes. Methods: This retrospective single-centre cohort study included adults with neurogenic lower urinary tract dysfunction who underwent first-time, non-urgent ultrasound-guided percutaneous suprapubic catheter placement between January 2019 and April 2025 and had documented follow-up for at least 30 days. Complications were graded according to the Clavien–Dindo classification; severe complications were defined as grade ≥ III. Potential risk factors were assessed using univariable logistic regression. Results: Of 300 screened patients, 287 were included. Within 30 days, 49/287 patients (17.1%; 95% CI 12.9–21.9) developed at least one complication, and 18/287 (6.3%; 95% CI 3.8–9.7) had a Clavien–Dindo grade ≥ III complication. Grade ≥ IIIb events occurred in 6/287 patients (2.1%; grade IIIb, n = 5; grade IV, n = 1). No confirmed bowel injury was observed. In an exploratory univariable analysis, diabetes mellitus showed a borderline unadjusted association with severe complications (OR 2.86; 95% CI 1.01–7.64; p = 0.049). No multivariable adjustment or multiplicity correction was performed. Conclusions: This study provides confirmatory real-world short-term safety data for selected patients with neurogenic lower urinary tract dysfunction who underwent ultrasound-guided trocar suprapubic catheter placement. No confirmed bowel injury was observed. The diabetes mellitus signal is hypothesis-generating and requires confirmation in larger studies.