Ultrasound-guided Placement of a Foley Catheter Using a Hydrophilic Guide Wire

Abstract

Acute urinary retention is a common problem in the emergency department. Patients can present in significant distress, necessitating the placement of a urinary catheter. Foley catheter placement can be difficult to accomplish depending on the etiology of the retention and the degree of the obstruction. In the case presented here, we used ultrasound guidance, a guidewire, and a Foley catheter to successfully relieve a patient’s urinary retention after multiple failed attempts.

POCUS for Visualization and Facilitation of Urinary Catheter Placement

“…The most severe complications is creation of a false passage, as this can result in pain, abscess formation, urethrocutaneous fistula, and infection [4]. The use of POCUS to facilitate placement of a urinary catheter over a hydrophilic guidewire in a patient with BPH and prior placement of suprapubic catheter has been reported [5]. Further, POCUS has been used to dynamically guide a Foley catheter into the uterine cavity to tamponade life-threatening post-procedure hemorrhage [6].…”

Point-of-Care Ultrasound (POCUS) for the Cardiothoracic Anesthesiologist

“…6 POCUS also has been used to diagnose obstructive nephropathy, 6 hydronephrosis, 105 nephrolithiasis, 106 and bladder distention, 107 as well as assisting in difficult Foley catheter placement. 108 All of these attributes make abdominal ultrasound ideally suited for routine use in the ICU.…”

FAST exam for the anesthesiologist

“…In addition, abdominal ultrasound can be used for procedural guidance. For example, studies demonstrate its usefulness in ensuring proper Foley catheter placement, intrauterine placement of catheters to tamponade hemorrhage, and as part of an algorithm to ensure appropriate placement of resuscitative endovascular balloon occlusion of the aorta (REBOA) devices following trauma 50–52. See Table 1 for a summary of the indications for the FAST exam in the trauma, critical care, and perioperative setting.…”