*** Operative Note Preoperative Diagnosis: @PRINCIPALPROBLEM@ Postoperative Diagnosis: Same Procedure(s) Performed: 1. Open suprapubic tube placement 2. Antegrade Cystourethroscopy Surgeons: @ORSURGPANEL@ Anesthesia: @ORANESSTAFF@ {pganesthesia:32268} Indications for Surgery: *** Operative Findings: *** Procedure Details: The patient was correctly identified in the preoperative holding area where written informed consent as well potential risks and complications were reviewed. The patient was brought back to the operative suite where a pre-induction timeout was performed. After correct information was verified, {pganesthesia:32269:o} was induced via {pganesthesia:32268:o}. The patient was then placed in {pgpositioning:32272:o} position. Sequential compression devices were placed for VTE prophylaxis. The patient was prepped and draped in the usual sterile fashion and appropriate peri-procedural antibiotics were administered. A second timeout was performed. We began by placing a straight glide-wire through the meatus and into the bladder and confirming we were in by placing a 5 Fr open-ended catheter over the wire into the bladder, removing the wire and drawing back until clear yellow urine. We then marked the midline at the pubic symphysis and made a 3 cm incision ending at the superior aspect of the pubis. Soft tissue was divided. Anterior rectus fascia opened in the midline. Rectus bellies were split. Transversalis fascia was opened. Bladder was overdistended with ~300mL sterile water. 1cm cystotomy was made, edges of the cystotomy were grasped with Alice. Antegrade cystoscopy was performed with the flexible cystoscope. We then pre-placed a purse-string suture using 2-0 Vicryl and secured an 18 Fr SPT into the bladder with secure, water-tight closure. Rectus fascia was closed with PDS. We took great care to ensure the SPT was not kinked and irrigated and drained without difficulty. We then closed the skin using multiple interrupted 3-0 chromic gut sutures. Local anesthetic was instilled in the suprapubic incision. A penile block was performed as well. 1/4 marcaine was used as the anesthetic agent. A small island dressing was placed over the suprapubic incision and the catheter was secured using tape and Stat-lock to ensure perpendicular entry into the abdomen. All instrument and lap counts were correct. Anesthesia was reversed and the patient awoke having tolerated the procedure without difficulty. Estimated Blood Loss: Minimal*** Drains: None Total IV Fluids: See anesthesia record Specimens: none Implants: @ORIMPLANT3@ Complications: None Disposition: {Op note disposition:31782} Condition: {stable/unstable:60080} Post-Op Plan/Instructions: 1. ***