Traumatic foley catheter removal

Background

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

Clinical Features

• Usually blood at the meatus

Differential Diagnosis

Genitourinary trauma

• Bladder trauma
• Urethral trauma
• Testicular trauma
• Penile trauma
• Vaginal trauma
• Sexual assault
• Child abuse

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

References

Authors

Ross Donaldson, Daniel Ostermayer, Neil Young