What is the name of the surgical procedure for neurogenic bladder that involves placing a catheter through the abdominal wall into the bladder for self-catheterization?

Suprapubic Catheterization (Suprapubic Cystostomy)

The surgical procedure you're describing is called a suprapubic cystostomy (or suprapubic catheter placement), which creates a tract through the abdominal wall directly into the bladder for intermittent self-catheterization. However, when this is combined with a continent mechanism for neurogenic bladder management, it may involve a Mitrofanoff procedure or similar continent catheterizable channel.

Key Terminology and Procedures

Suprapubic Cystostomy

• A suprapubic catheter is placed through the abdominal wall directly into the bladder, creating an alternative route for bladder drainage when urethral catheterization is not feasible 1
• This approach is preferred over long-term indwelling urethral catheters due to reduced risk of urethral erosion and destruction 1, 2

Mitrofanoff Procedure (Continent Catheterizable Conduit)

• The Mitrofanoff procedure creates a continent catheterizable channel, typically using the appendix or a reconfigured segment of ileum, connecting the bladder to the abdominal wall 3, 4
• This allows patients to perform clean intermittent self-catheterization through a small abdominal stoma rather than through the urethra 5
• The procedure is specifically indicated for neurogenic bladder patients who cannot catheterize through the native urethra 3, 4, 6

Clinical Context and Indications

When These Procedures Are Used

• Neurogenic bladder is the most common indication, accounting for the majority of cases requiring alternative catheterization routes 3, 4
• Other indications include urethral trauma/stricture, posterior urethral valves, and bladder exstrophy 4
• The procedure should only be used when the native urethra is not suitable for catheterization 3

Advantages Over Urethral Catheterization

• Intermittent catheterization through a suprapubic route is strongly preferred over indwelling urethral catheters for long-term bladder management 2
• Indwelling urethral catheters carry high risks of catheter-associated UTIs, urethral erosion/destruction, and urolithiasis 7, 1
• Chronic indwelling catheters can cause devastating complications including patulous urethra and complete bladder neck destruction 6

Important Clinical Considerations

Complications and Maintenance Requirements

• Stomal stenosis is the most common complication, occurring in 13-50% of patients, typically within the first year 3, 4
• Other complications include conduit leakage (26.5%), stricture (14.7%), and conduit angulation 3
• Approximately 61% of patients require operative revision, most commonly within the first 2 years 3
• Patients and families must be prepared for the complexity and potential complications of these procedures 3

Patient Selection Criteria

• Patients must be able and willing to perform self-catheterization regularly 7
• Adequate manual dexterity and cognitive ability are essential for successful long-term management 5
• The procedure is often combined with augmentation cystoplasty in patients with poor bladder compliance 4, 8

Long-term Management

• Clean intermittent self-catheterization (CISC) through the continent stoma is the standard approach 6, 5
• Regular follow-up is essential to monitor for complications and ensure proper technique 3, 4
• The Mitrofanoff procedure has demonstrated durable outcomes over long-term follow-up when properly maintained 4, 6