Mechanical suction for clot evacuation: experience with "suction bridge" for safe and effective clot removal

To present the experience with the use of a "suction bridge" for removal of bladder clots. In all patients presenting with bladder clots, mechanical suction was done using a "suction bridge". This bridge has a luer lock that is fixed to the cystoscope sheath, and the other end is connected to suction tube. The suction pressure was started at 250 mmHg and was increased up to 400 mmHg if needed. Twenty patients with a mean age of 59.4 years were included. The etiologies of bladder clots included bladder tumor in nine, benign prostate hyperplasia (BPH) in two, BPH with bladder stone in one, hematochyluria in three, and post-transurethral prostate resection in 10. Eighteen patients presented in clot retention. The estimated clot size ranged from 50 mL to more than 1 L. The mean duration for clot removal was 15 min (range 5-60). The procedure was successful in all patients. There was no bladder injury. The limitations include the small number of recruits, the non-randomized nature of study, and no control group for comparison. Mechanical suction is another safe, fast, and effective option of clot removal from the urinary bladder. The suction bridge is useful while using this method.