Traumatic foley catheter removal

Background

Penis anatomy

The human male urethra laid open on its anterior (upper) surface.

Transverse section of the penis.

• Altered male patient pulls out Foley catheter with the balloon still inflated

Clinical Features

• Usually blood at the meatus

Differential Diagnosis

Genitourinary Trauma

• Urinary system
  • Renal trauma
  • Ureter trauma
  • Bladder trauma
  • Urethral trauma
    • Traumatic foley catheter removal
• Genital
  • Penile trauma
    • Traumatic foley catheter removal
  • Testicular trauma
  • Vaginal trauma
• Other
  • Child abuse
  • Pelvic fracture (often accompanies)
  • Sexual assault

Evaluation

• Clinical

Management

• Little prospective epidemiological data on type of injury or management
• Does not usually result in massive urethral injury
• Suggested approach
  • Gently pass another Foley catheter
    • Avoids urethral obstruction by tears or clots and allows healing of urethral trauma
    • Irrigate bladder to remove blood
  • If does not gently pass, consult urology

Prevention

• Large ace bandage around patient's leg to obscure the majority of the catheter
• Decoy Catheter(s)
  • Tuck real catheter between patient's legs and taped it to the back of leg
  • Tuck one to multiple dummy Foleys that the patient can reach (and intermittently pull on to keep busy)

See Also

• Genitourinary Trauma