Knotted urethral catheter: an unusual complication in adults

Abstract

Knotting of feeding tubes or urinary catheters has been reported as a rare complication in paediatrics when draining the bladder. This is caused by inserting thin flexible tubes too far in, allowing it to coil. We present a case of a 70-year-old woman who was catheterised during a routine spinal surgery, and the catheter coiled and balloon failed to deflate requiring a cystostopic approach to puncture the balloon and remove it. Awareness of this complication in female catheterisation and education on length of catheter insertion is important to avoid this.

Rare case of urethral catheter knot formation in a woman during elective surgery

“…Mulawkar [6] reported knot formation in a 14-Fr straight urethral catheter during self-catheterization in a female adult patient. In both case reports, the authors suggested that the passage of an excessively long catheter might have caused catheter coiling and subsequent knotting in these female patients [5,6]. In women, it is unnecessary to fully insert the urethral catheter because the average length of the female urethra is 4 cm [5].…”

“…In both case reports, the authors suggested that the passage of an excessively long catheter might have caused catheter coiling and subsequent knotting in these female patients [5,6]. In women, it is unnecessary to fully insert the urethral catheter because the average length of the female urethra is 4 cm [5]. Therefore, we can usually confirm urine outflow within that depth.…”

“…Jallad et al [5] reported that a 12-Fr Foley urethral catheter became knotted in a female adult patient. Mulawkar [6] reported knot formation in a 14-Fr straight urethral catheter during self-catheterization in a female adult patient.…”

“…In our case, it was possible to remove the catheter even with knot formation. However, some urethral catheter knots require cystoscopy to puncture the balloon or to permit the use of a holmium laser to ablate the knot to achieve catheter removal [5,6]. Thus, clinicians should be aware that female patients may be at the highest risk for urethral catheter knot formation.…”