This patient has had a suprapubic cystostomy with placement of a suprapubic catheter. The catheter passes percutaneously above the pubic symphysis into the bladder.
Suprapubic cystostomy may be required in patients who have urinary obstruction either when the urethra cannot be catheterised, or when a long term indwelling catheter is required.
A long term catheter was required in this paralysed patient. Urinary stasis has led to development of bladder stones.