Bowel perforation, intraabdominal visceral injury, uncontrolled hemorrhage, vascular injury, peritonitis, catheter misplacement, and catheter migration are the major complications of suprapubic cystostomy catheter placement.1–11 Perforation of the bowel can be prevented by ensuring that the bladder is distended by palpation, percussion, or ultrasonography. Intraperitoneal perforation is more common in patients with ascites, a distended abdomen, or prior abdominal surgery. Gross hematuria is common and transient. Through-and-through perforation of the bladder can injure the rectum, vagina, and/or uterus. Other minor complications are associated with length of indwelling catheter time and include infections (e.g., cellulitis and abscesses), occasional bleeding, and stone formation.