Managing The Nondeflating Urethral Catheter

Abstract

Background: Urethral catheterization is a routinely perfonned procedure in hospitalized patients. Numerous complications have been reported secondary to urethral catheter placement.Methods: The medical literature was searched using the following key words: "urethral catheter," "complications," and "management." A case report is described and a review of the literature is provided to assist in managing the nondetlating urethral catheter balloon.

Management of Retained Foley’s Catheter

“…Shapiro et al presented a management algorithm for RFC. His observation was similar to those made in this study [7]. Hollingsworth et al found that 31% of his patients needed cutting of the side port to deflate the balloon while in 15% guide-wire had to be inserted.…”

“…Among all the chemicals used for this purpose, mineral oil has been found to cause the least damage to the bladder [11]. If urine is present in the bladder when chemicals are used, chemicals get diluted and this lessens their concentration leading to lessened chances of bladder damage [7]. Although we used mineral oil successfully in just one patient, he had hematuria for two days which resolved on conservative treatment.…”

“…If the guide-wire goes in easily but fluid does not come out, some investigators have recommended using a 22 G CVP catheter over the guide-wire allowing the balloon to drain as the CVP tip goes into the balloon [7]. But, these catheters are not cost effective in poor countries and setup like ours.…”

Algorithm Proposal to Remove a Non-Deflatable Bladder Catheter

“…Each of them has advantages and disadvantages (2,4). The dissolution of the ball wall with chemical substances (3a) includes various substances such as ether, chloroform, benzene, acetone and mineral oil (2,3,4,5). Although it is a quick and effective system to break the globe, it presents some serious inconveniences.…”

“…When this technique is not effective, it is necessary to resort to maneuvers that involve the rupture of the ball for which there are several options that we have to summarize into 3 groups (Fig 3 Step 3): Chemical dissolution (3a), ball puncture (3b) and hyper filling (3c). Each of them has advantages and disadvantages (2,4). The dissolution of the ball wall with chemical substances (3a) includes various substances such as ether, chloroform, benzene, acetone and mineral oil (2,3,4,5).…”