Long-term outcomes of urethral catheterisation injuries: a prospective multi-institutional study

N. F. Davis, N. R. Bhatt, E. MacCraith, H. D. Flood, R. Mooney, G. Leonard, M. T. Walsh

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: There are no prospective data describing the incidence and spectrum of long-term complications associated with traumatic urethral catheterisation (UC). We prospectively monitored the long-term clinical outcomes and complications of patients with traumatic UC injuries. Methods: A prospective study at two tertiary university hospitals was performed to record all referrals for iatrogenic urethral injuries caused by UC. Long-term follow-up was prospectively maintained by regular outpatient department visits and by monitoring all urological interventions and their outcomes from urinary catheter-related injuries. Results: The incidence of traumatic UC was 13.4 per 1000 catheters inserted in male patients and 37 iatrogenic urethral injuries were recorded. The mean age was 74 ± 12 years and the mean length of follow-up was 37 ± 3.7 months. Urethral injuries were caused by inflating the catheter anchoring balloon in the urethra (n = 26) or by creating a false passage with the catheter tip (n = 11). In total, 29 patients (78%) developed urethral stricture disease during their follow-up; of which 11 have required at least one urethral dilation and two have required one urethrotomy. Three patients required long-term indwelling suprapubic catheter placement and seven patients opted for a long-term indwelling urethral catheter. There were eight patient mortalities; one of which was due to severe urosepsis resulting from catheter balloon inflation in the urethra. Conclusion: Catheter-related injuries are associated with significant long-term complications in this vulnerable patient cohort. In future, such injuries may be preventable if the safety profile of the urinary catheter is modified.

Original languageEnglish
Pages (from-to)473-480
Number of pages8
JournalWorld Journal of Urology
Volume38
Issue number2
DOIs
Publication statusPublished - 1 Feb 2020

Keywords

  • Catheterisation
  • Iatrogenic injury
  • Urethra
  • Urethral stricture
  • Urinary catheter

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