scholarly journals Unusual Complication of Suprapubic Cystostomy in a Male Patient with Tetraplegia: Traction on Foley Catheter Leading to Extrusion of Foley Balloon from Urinary Bladder and Suprapubic Urinary Fistula – Importance of Securely Anchoring Suprapubic Catheter with Adhesive Tape or BioDerm Tube Holder

2007 ◽  
Vol 7 ◽  
pp. 1575-1578 ◽  
Author(s):  
Subramanian Vaidyanathan ◽  
Peter L. Hughes ◽  
Bakul M. Soni
Keyword(s):  
Urinary Bladder ◽  
Anterior Abdominal Wall ◽  
Foley Catheter ◽  
Urethral Catheter ◽  
Adhesive Tape ◽  
Suprapubic Catheter ◽  
Catheter Drainage ◽  
Suprapubic Cystostomy ◽  
Urine Leak

Suprapubic cystostomy is recommended to patients with neuropathic bladder to prevent complications of long-term urethral catheter drainage. We present a 50-year-old male patient with tetraplegia who had long-term urethral catheter drainage. Following flexible cystoscopy, he developed a urine leak from the right side of the scrotum. Suprapubic cystostomy was performed. After suprapubic cystostomy, the urinary fistula healed completely. A follow-up cystourethrogram confirmed an intact urethra with no leak of contrast. Six weeks later, this patient presented with a hole below the suprapubic cystostomy through which a small amount of urine was leaking. A keyhole dressing had been applied around the suprapubic catheter and the catheter was hanging loosely, thus permitting traction on the catheter, especially when the urine bag was full. Computerised tomography of the pelvis showed extrusion of the Foley balloon from the urinary bladder, but the tip of the catheter was still located within the bladder. The extruded catheter was removed and a Foley catheter was inserted, ensuring that the balloon was inflated within the urinary bladder. The suprapubic catheter was secured firmly to the anterior abdominal wall with a BioDerm Tube Holder, thus preventing any traction on the catheter or Foley balloon. The urine leak through the hole below the suprapubic cystostomy stopped and the sinus healed. This case illustrates the need to anchor the suprapubic catheter securely to the anterior abdominal wall with adhesive tape or BioDerm Tube Holder to prevent traction and consequent displacement of the catheter or Foley balloon.

scholarly journals Synostosis Between Pubic Bones due to Neurogenic, Heterotopic Ossification

2006 ◽  
Vol 6 ◽  
pp. 2486-2490 ◽  
Author(s):  
Subramanian Vaidyanathan ◽  
Peter L. Hughes ◽  
Bakul M. Soni
Keyword(s):  
Bone Formation ◽  
Heterotopic Ossification ◽  
Foley Catheter ◽  
Symphysis Pubis ◽  
Heterotopic Bone ◽  
Heterotopic Bone Formation ◽  
Suprapubic Catheter ◽  
Suprapubic Cystostomy ◽  
Urine Leak ◽  
Irregular Margin

Neurogenic, heterotopic ossification is characterised by the formation of new, extraosseous (ectopic) bone in soft tissue in patients with neurological disorders. A 33-year-old female, who was born with spina bifida, paraplegia, and diastasis of symphysis pubis, had indwelling urethral catheter drainage and was using oxybutynin bladder instillations. She was prescribed diuretic for swelling of feet, which aggravated bypassing of catheter. Hence, suprapubic cystostomy was performed. Despite anticholinergic therapy, there was chronic urine leak around the suprapubic catheter and per urethra. Therefore, the urethra was mobilised and closed. After closure of the urethra, there was no urine leak from the urethra, but urine leak persisted around the suprapubic catheter. Cystogram confirmed the presence of a Foley balloon inside the bladder; there was no urinary fistula. The Foley balloon ruptured frequently, leading to extrusion of the Foley catheter. X-ray of abdomen showed heterotopic bone formation bridging the gap across diastasis of symphysis pubis. CT of pelvis revealed heterotopic bone lying in close proximity to the balloon of the Foley catheter; the sharp edge of heterotopic bone probably acted like a saw and led to frequent rupture of the balloon of the Foley catheter. Unique features of this case are: (1) temporal relationship of heterotopic bone formation to suprapubic cystostomy and chronic urine leak; (2) occurrence of heterotopic ossification in pubic region; (3) complications of heterotopic bone formation viz. frequent rupture of the balloon of the Foley catheter by the irregular margin of heterotopic bone and difficulty in insertion of suprapubic catheter because the heterotopic bone encroached on the suprapubic track; (4) synostosis between pubic bones as a result of heterotopic ossification..Common aetiological factors for neurogenic, heterotopic ossification, such as forceful manipulation, trauma, or spasticity, were absent in this patient. Since heterotopic bone formation was observed in the pubic region after suprapubic cystostomy and chronic urine leak, it is possible that risk factors related to the urinary tract might have played a role in heterotopic bone formation, which resulted in synostosis between pubic bones.

scholarly journals Long-term urethral catheter drainage.

BMJ ◽  
1979 ◽  
Vol 2 (6201) ◽  
pp. 1367-1367 ◽  
Author(s):  
E Riches
Keyword(s):  
Urethral Catheter ◽  
Catheter Drainage

scholarly journals Long-term urethral catheter drainage.

BMJ ◽  
1979 ◽  
Vol 2 (6197) ◽  
pp. 1046-1047 ◽  
Author(s):  
B G Ferrie ◽  
E S Glen ◽  
B Hunter
Keyword(s):  
Urethral Catheter ◽  
Catheter Drainage

scholarly journals Bladder injuries during obstetrical and gynecological surgeries

2017 ◽  
Vol 4 (7) ◽  
pp. 2177
Author(s):  
Beena Vaidya ◽  
Manish Chaudhari ◽  
Deep Parmar ◽  
Vipul Chaudhari ◽  
Taha Daginawala ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Bladder ◽  
Primary Repair ◽  
Bladder Injury ◽  
Interventional Study ◽  
Suprapubic Cystostomy ◽  
Urinary Tract Injury ◽  
Bladder Injuries ◽  
Gynaecologic Surgery

Background: The reproductive and urinary tracts in women are closely related anatomically and embryologically. Knowledge of this anatomy plays an important role in the prevention of urinary tract injury during gynaecologic surgery. The primary approach to prevention is careful surgical dissection and knowledge of the position of urinary tract structures within the surgical field.Methods: Prospective interventional study consisted of 28 patients with obstetrics and gynecological surgeries was carried out at department of surgery, new civil hospital, Surat during December 15th to January 16th. Out of 28 patients 13 patients had bladder injuries which repaired and studied in detail.Results: Out of these 28 patients undergone various obstetrics and gynecological surgeries, 13 patients were having iatrogenic urinary bladder injuries. Bladder injury occurred commonly during in LSCS and in hysterectomies. Out of 13 urinary bladder injuries, 8 injuries repaired in 2 layers by Vicryl 2-0 without insertion of SPC and 5 injuries were managed by primary repair with vicryl 2-0 with insertion of SPC (SPC= suprapubic cystostomy).Conclusions: Surgery adjacent to or within urinary bladder continue to result in occasional iatrogenic injury. These injuries can be minor with no long-term sequelae, or they can result in significant morbidity and inconvenience to patients.

scholarly journals The Surgical Risk of Suprapubic Catheter Insertion and Long-Term Sequelae

2006 ◽  
Vol 88 (2) ◽  
pp. 210-213 ◽  
Author(s):  
RS Ahluwalia ◽  
N Johal ◽  
C Kouriefs ◽  
G Kooiman ◽  
Bruce SI Montgomery ◽  
...  
Keyword(s):  
Urethral Catheter ◽  
Suprapubic Catheter ◽  
High Patient Satisfaction ◽  
Bladder Drainage ◽  
Satisfaction Rate ◽  
Published Evidence ◽  
Accident And Emergency ◽  
Complications Rate ◽  
Patient Satisfaction Rate

INTRODUCTION Suprapubic catheter (SPC) insertion is a common urological procedure, which is often referred to as safe and simple even in inexperienced hands. There is, however, very little published evidence on the safety of this procedure. Our study aimed to provide evidence on the associated morbidity and mortality and provide guidance for practising clinicians. PATIENTS AND METHODS A total of 219 patients who underwent SPC insertion under cystoscopic guidance at two urology institutions between 1994 and 2002 were identified and their case notes reviewed. RESULTS The intra-operative complication rate was 10% and the 30-day complications rate was 19%. Mortality rate was 1.8%. Long-term complications included recurrent UTIs (21%), catheter blockage (25%) resulting in multiple accident and emergency attendance (43%). Despite this, the satisfaction rate was high (72%) and most patients (89%) prefer the SPC over the urethral catheter. CONCLUSIONS SPC bladder drainage results in a high patient satisfaction rate. Patients and clinicians should be aware of the potential complications associated with SPC insertion.

scholarly journals Long-term urethral catheter drainage.

BMJ ◽  
1979 ◽  
Vol 2 (6201) ◽  
pp. 1367-1367
Author(s):  
S L Jackson
Keyword(s):  
Urethral Catheter ◽  
Catheter Drainage

scholarly journals Intraperitoneal Urinary Bladder Perforation Observed in a Patient with an Indwelling Urethral Catheter

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Soichiro Ogawa ◽  
Tomonori Date ◽  
Osamu Muraki
Keyword(s):  
Urinary Bladder ◽  
Peritoneal Cavity ◽  
Home Visiting ◽  
Foley Catheter ◽  
Contrast Material ◽  
Exploratory Laparotomy ◽  
Urethral Catheter ◽  
Bladder Perforation ◽  
Bladder Irrigation ◽  
Catheter Exchange

This report describes a rare case of an 86-year-old man with an indwelling urethral catheter who developed severe abdominal pain and was diagnosed with intraperitoneal urinary bladder perforation. A home-visiting nurse suspected catheter obstruction and performed a catheter exchange. However, bladder irrigation could not subsequently be performed. Computed tomography of the abdomen and pelvis after transurethral perfusion of contrast medium demonstrated extravasation of the contrast material into the peritoneal cavity. Furthermore, the Foley catheter balloon was positioned in the peritoneal cavity through the bladder. The patient was diagnosed with peritonitis due to spontaneous intraperitoneal perforation of the urinary bladder, and exploratory laparotomy was performed. During exploration, a perforated tear at the top of the bladder was discovered where the Foley catheter had penetrated the bladder. The Foley catheter balloon was floating freely in the peritoneal cavity. There was no evidence of pathologic lesions, such as cancer or inflammatory mass at the site of the injured peritoneum. Successful closure of the damaged peritoneum and bladder was performed. Since the proportion of elderly individuals continues to increase in the general Japanese population, the incidence of the chronic Foley catheterization is expected to increase. Therefore, clinicians should be aware of this potential complication.

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