Delay in diagnosis of urethral perforation due to catheterisation in a person with cervical spinal cord injury. Importance of (1) imaging studies done promptly for detection and documentation of urethral trauma, (2) Urethrotech catheterisation device to minimise urethral trauma and achieve successful catheterisation: A case report.
Cervical spinal cord injury
Iatrogenic
Penile urethra
Suprapubic cystostomy
Urethral catheterisation
Urethral catheterisation device
Journal
International journal of surgery case reports
ISSN: 2210-2612
Titre abrégé: Int J Surg Case Rep
Pays: Netherlands
ID NLM: 101529872
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
24
09
2023
revised:
18
10
2023
accepted:
21
10
2023
medline:
27
10
2023
pubmed:
27
10
2023
entrez:
26
10
2023
Statut:
ppublish
Résumé
Spinal cord injury patients are at risk for urethral trauma during catheterisation. We report a patient in whom urethral perforation due to catheterisation was not recognised for ∼ four days. Following a routine catheter change by community nurses in a male person with tetraplegia, the catheter drained only a small amount of urine. Therefore, the patient attended the hospital where the staff removed the catheter but could not place a new catheter. The doctor tried different catheters and on fifth attempt, inserted a catheter. The patient continued to bypass urine and was prescribed Solifenacin. On self-referral to spinal unit, urethral trauma was suspected. CT of pelvis revealed the balloon of the Foley catheter in the penile urethra at penis base with the tip projecting beyond the penile shaft. Suprapubic cystostomy was done. The patient continued to leak urine from the penis; required penile sheath drainage and an additional leg bag. This case illustrates the value of CT of pelvis including the penis in detecting urethral trauma and misplacement of the catheter. Physicians should look for symptoms and signs of urethral trauma and incorrect positioning of the catheter. Imaging studies should be done without delay to assess urethral trauma and misplacement of urinary catheter. We use Urethrotech urethral catheterisation in patients in whom the first attempt to insert a catheter per urethra is unsuccessful, or in patients with a history of difficult catheterisation. This helped to minimise urethral trauma and achieve successful catheterisation.
Identifiants
pubmed: 37883868
pii: S2210-2612(23)01105-7
doi: 10.1016/j.ijscr.2023.108976
pmc: PMC10667899
pii:
doi:
Types de publication
Case Reports
Langues
eng
Pagination
108976Informations de copyright
Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of interest statement There is no conflict of interest.
Références
ScientificWorldJournal. 2006 Jun 20;6:2445-9
pubmed: 17619716
Ann R Coll Surg Engl. 2010 Apr;92(3):259
pubmed: 20425888
Case Rep Urol. 2022 Jun 15;2022:8656233
pubmed: 35754919
J Mater Sci Mater Med. 2013 Aug;24(8):1825-35
pubmed: 23661258
Int J Surg. 2020 Dec;84:226-230
pubmed: 33181358
Cases J. 2008 Jul 17;1(1):43
pubmed: 18637181
Int Braz J Urol. 2008 Jul-Aug;34(4):401-11; discussion 412
pubmed: 18778491