Acute urinary retention and the difficult catheterization

Sliwinski, Ania; D’Arcy, Frank; Sultana, Ron; Lawrentschuk, Nathan

doi:10.1097/mej.0000000000000334

Cited by 14 publications

(13 citation statements)

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“…These patients often require late permanent treatment. 6 In present case, further endoscopic treatment on the spot was considered an upright decision.…”

Section: Discussionmentioning

confidence: 85%

Accidental prostatic stone finding after urinary catheterization failure during hernia surgery

et al. 2018

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Urethral stones represent a rare cause of urinary obstruction and they are usually symptomatic. In older patients with bladder outlet obstruction, bladder stones are commonly found and managed accordingly. Intraprostatic stone formation is also a common finding in men with benign prostate hyperplasia but rarely is it a factor for obstruction. On the contrary, large stone formation in the prostatic urethra is a rare entity, and patients present with hematuria, dysuria, infection or retention in most of the cases. Patients previously submitted to urological procedures such as prostatectomy or lithotripsy, are at high risk of developing late complications and need a long follow-up. In cases with obstruction due to urethral stones the management is straightforward but in asymptomatic patients the diagnosis is usually missed or delayed. Therefore, careful evaluation of the patient is essential in order to prevent any unwanted situation such as catheterization failure. Authors’ present a case of an 82-year-old male who accidentally diagnosed with a large stone impacted in the prostatic cavity after urinary catheterization failure during a scheduled open hernia repair surgery. The patient had a history of previous open prostatectomy and he was completely asymptomatic. An emergency cystoscopic evaluation revealed the cause of the prostatic urethral obstruction. The urinary stone was subsequently managed endoscopically on the spot.

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“…These patients often require late permanent treatment. 6 In present case, further endoscopic treatment on the spot was considered an upright decision.…”

Section: Discussionmentioning

confidence: 85%

Accidental prostatic stone finding after urinary catheterization failure during hernia surgery

et al. 2018

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“…Our main intention is to overpass this lack of formation by refreshing readers the principles of urethral catheterization, showing some tips and tricks that may be helpful in the blind placement of urethral catheters and finally remaining post catheterization care recommendations. All together may assure a safe probe placement that will avoid complications for the patient, difficulties for the physicians and will reduce cost of sanitary attention (1,5).…”

Section: Discussionmentioning

confidence: 99%

“…Silicone material adds stiffness and limits coiling which is ideal for advancing through medium-sized strictures and bladder neck contractures. However, these catheters are potentially harmful and never have to force or make excessive pressure for the risk of false passage (1,5,6,7,8). Placement of a urethral catheter assisted with a guidewire is an excellent option in cases of difficult catheterization.…”

Section: Figure 1: Urethral Angulation False Passage Production and mentioning

confidence: 99%

“…Then, elongate penis in an upright position at ≈30° angle respects the horizontal line by tractioning the plans penis without compressing underlying urethra. This maneuver will reduce the angle between posterior and prostatic urethra facilitating catheter insertion and passage through external sphincter (1,7,8). Four, in cases of prostatic hyperplasia, the angle between posterior a prostatic urethra is increased difficulting catheter pass through the sphincteric urethra.…”

Section: Catheter Placementmentioning

confidence: 99%

“…Male catheterization, in particular, can be difficult, especially in patients with enlarged prostate glands or other potentially obstructive conditions in the lower urinary tract (1,2,3,4). Solutions to problematic urinary catheterization are not well known and, when it occurs, the risk of failed catheterization and concomitant complications increase.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Tips and Tricks for Difficult Urethral Catheterization

Leon-Mata¹,

Arias-Sanmiguel²,

Iglesias-Seoane³

et al. 2017

IAM

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Male urethral catheterization may be difficult in patients with enlarged prostate glands or other potentially obstructive conditions as urethral stenosis, after prostatic TUR undermining bladder neck, old and recent false passages, sphincteric spasm among others. Alternative techniques or tricks to surpass problematic urinary catheterization are usually known by experienced nurses and physicians. If repeated catheterization attempts are done, the risk of failing and complications appearing increase significantly. Improper insertion of catheters also may increase healthcare costs due to prolonged hospitalization, immediate and/or delayed surgical interventions transforming a minor technique into a huge problem for the patient, doctors, and healthcare system. Improved techniques for catheter placement are essential for all healthcare personnel involved in the management of the patient needing a urethral catheterization, including nurses and doctors from both primary and hospital medicine. The aim of this article is to show some tips and tricks that may be helpful for the blind placement of urethral catheters. The phrase "primum non nocere" acquires its maximum meaning in this context. Sanitary personal must be prudent in the number of attempts, have a clear strategy of what can be done in each moment and know how to stop or seek help in case of not being able to probe the patient in 2 or 3 attempts. If all these recommendations fail a urologist have to be required to place a catheter in a safe way including the use of endoscopic optic devices.

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Management of Common Urologic Conditions Among the Critically Ill

Osterberg

2018

Surgical Critical Care Therapy

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Acute urinary retention and the difficult catheterization

Cited by 14 publications

References 0 publications

Accidental prostatic stone finding after urinary catheterization failure during hernia surgery

Accidental prostatic stone finding after urinary catheterization failure during hernia surgery

Tips and Tricks for Difficult Urethral Catheterization

Management of Common Urologic Conditions Among the Critically Ill

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