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

  • N. F. DavisEmail author
  • N. R. Bhatt
  • E. MacCraith
  • H. D. Flood
  • R. Mooney
  • G. Leonard
  • M. T. Walsh
Original Article

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.

Keywords

Urethra Catheterisation Urinary catheter Iatrogenic injury Urethral stricture 

Notes

Author contributions

NFD: data collection, data analysis, manuscript writing. NRB: data collection, data analysis. EM: data collection, data analysis. HF: manuscript writing, supervision. RM: project development. GL: project development. MW: manuscript writing, supervision.

Funding

The authors declare that no funding was received for this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Research involving human rights and animal participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standard.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of UrologyBeaumont and Connolly HospitalsDublinIreland
  2. 2.Royal College of Surgeons in Ireland (RCSI)DublinIreland
  3. 3.Department of UrologyTallaght HospitalDublinIreland
  4. 4.Department of UrologySt Vincent’s University HospitalDublinIreland
  5. 5.School of EngineeringBernal Institute and the Health Research Institute, University of LimerickLimerickIreland
  6. 6.Department of UrologyThe Austin HospitalMelbourneAustralia

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