Ureteral rupture from aberrant Foley catheter placement: A case report

Abstract

We present the case of a 59 year old female with history of severe neurologic dysfunction from advanced multiple sclerosis who presented with lethargy and oliguria several hours after urethral Foley catheterization. A contrast-enhanced CT scan of the abdomen/pelvis showed an aberrantly placed Foley catheter with its balloon inflated in the proximal left ureter, a rare complication of Foley catheterization with only 5 other cases reported. Incomplete ureteral rupture was demonstrated and confirmed by a followup CT scan in the urographic phase. One of our institution's Interventional Radiologists then placed a nephroureteral stent across the injured ureter to facilitate healing. The patient expired 9 days after the procedure from unrelated sepsis from a chronic stage IV decubitus ulcer, so long term monitoring could not be performed. Following description of our case, we conduct a literature review of presentations, imaging characteristics, and treatment of ureteral Foley catheter placement.

Ureteral Rupture Caused by a Suprapubic Catheter in a Male Patient With Spinal Cord Injury: A Case Report

“…Frickmann et al [4] reported one case of ureteral rupture during a suprapubic vesical catheter change in a patient with prostate adenoma. The other two cases of ureteral rupture after urethral Foley catheterization were reported in female patients [56]. The case reported here is the first case of ureteral rupture induced by an indwelling suprapubic catheter in a male patient with neurogenic bladder caused by SCI.…”

“…Catheter localization in the ureter is a rare complication; in fact, only 17 cases of an indwelling urethral or suprapubic catheter located in the ureter have been reported to date, among which three cases showed ureteral rupture after catheterization [456]. …”

Life‐threatening urethral hemorrhage after placement of a Foley catheter in a patient with uroseptic disseminated intravascular coagulation due to chronic urinary retention induced by untreated benign prostatic hyperplasia

“…1 Gentle insertion of the catheter should always be undertaken because forceful and rough manipulation during catheterization induces urethral injury. 2 Life-threatening adverse effects induced by Foley catheter insertion, such as urethral rupture, are not frequent, 3 and previous studies have shown that placement can be safely achieved even by medical staff members other than urology experts. 4,5 Placement of a Foley catheter was necessary to resolve the urinary retention in this case.…”

Pyélonéphrite obstructive par cathétérisation du méat urétéral par une sonde vésicale

“…Les lésions iatrogènes sont secondaires à des interventions urologiques (42 %), gynécologiques (34 %) ou de chirurgie générale (24 %). L'uretère distal est majoritairement en cause (91 %) [1].…”