摘要 We describe three cases of inadvertent placement of the urinary catheter into the ureter. An 85-year-old gentleman on long-term indwelling catheter (IDC) for neurogenic bladder presented with fever and right flank pain. CT of abdomen and pelvis demonstrated the tip of the IDC to be located within the right vesicoureteric junction with acute right hydronephrosis and acute pyelonephritis. A 74-year-old woman, on long-term IDC for neurogenic bladder was found to have hydronephrosis on ultrasound imaging. Contrast-enhanced CT intravenous pyelography done subsequently showed the IDC was in the right distal ureter. A 47-year-old lady, on IDC for urinary retention and voiding dysfunction likely secondary to schizophrenia and anti-psychotic medications, presented with raised creatinine. A non-enhanced CT of her abdomen and pelvis was done and showed that the tip of the urethral IDC was located up to the left vesicoureteric junction. In all patients, the hydronephrosis resolved after changing the catheter and they were well on discharge. We also review the literature to identify the incidence, outcomes and possible risk factors. To our knowledge, only 20 cases have been reported thus far in the English literature. Although serious complications can occur, the incidence is very low. One risk factor that has been identified is long-term catheterization in patients with neurogenic bladder. We do not recommend routine imaging after catheterization in this group of patients. However, we should still be mindful of the possibility of this occurrence and evaluate and treat as necessary when clinical suspicion arises.
Abstract: We describe three cases of inadvertent placement of the urinary catheter into the ureter. An 85-year-old gentleman on long-term indwelling catheter (IDC) for neurogenic bladder presented with fever and right flank pain. CT of abdomen and pelvis demonstrated the tip of the IDC to be located within the right vesicoureteric junction with acute right hydronephrosis and acute pyelonephritis. A 74-year-old woman, on long-term IDC for neurogenic bladder was found to have hydronephrosis on ultrasound imaging. Contrast-enhanced CT intravenous pyelography done subsequently showed the IDC was in the right distal ureter. A 47-year-old lady, on IDC for urinary retention and voiding dysfunction likely secondary to schizophrenia and anti-psychotic medications, presented with raised creatinine. A non-enhanced CT of her abdomen and pelvis was done and showed that the tip of the urethral IDC was located up to the left vesicoureteric junction. In all patients, the hydronephrosis resolved after changing the catheter and they were well on discharge. We also review the literature to identify the incidence, outcomes and possible risk factors. To our knowledge, only 20 cases have been reported thus far in the English literature. Although serious complications can occur, the incidence is very low. One risk factor that has been identified is long-term catheterization in patients with neurogenic bladder. We do not recommend routine imaging after catheterization in this group of patients. However, we should still be mindful of the possibility of this occurrence and evaluate and treat as necessary when clinical suspicion arises.
Rui Luo, Song Liang Lee, Foo Cheong Ng, Li-Tsa Koh. Inadvertent placement of a urinary catheter into the ureter:A report of 3 cases and review of the literature[J]. Asian Journal of Urology, 2017, 4(4): 256-261.
Rui Luo, Song Liang Lee, Foo Cheong Ng, Li-Tsa Koh. Inadvertent placement of a urinary catheter into the ureter:A report of 3 cases and review of the literature. Asian Journal of Urology, 2017, 4(4): 256-261.
[1] Borrero GO, Miller PR, Vora K, Nepjuk CA. Acute ureteral obstruction as a complication of suprapubic catheterization. Urol Radiol 1987;9:171-3. [2] Singh NP, Eardley I. An uncommon complication of urethral catheterization. Br J Urol 1996;77:316-7. [3] Kato H. Incorrect positioning of an indwelling urethral catheter in the ureter. Int J Urol 1997;4:417-8. [4] Ogan K, Berger RM. Aberrant Foley catheter placement into the proximal right ureter. BJU Int 2001;88:124. [5] Muneer A, Minhas S, Harrison SC. Aberrant Foley catheter placement into the proximal right ureter. BJU Int 2002;89:795. [6] Hara N, Koike H, Bilim V, Takahashi K. Placement of a urethral catheter into the ureter:an unexpected complication after retropubic suspension. Int J Urol 2005;12:217-9. [7] George J, Tharion G. Transient hydroureteronephrosis caused by a Foley's catheter tip in the right ureter. ScientificWorldJournal 2005;5:367-9. [8] Wang D, Foote A. A rare complication of an indwelling urinary catheter e ureteral entrapment. Aust N Z J Obestet Gynaecol 2006;46:459-60. [9] Maegele M, Gruetzner U, Wenzel D. Transurethral catheter in the distal ureter as a cause for acute abdominal pain. Emerg Med J 2007;24:599. [10] Kim MK, Park K. Unusual complication of urethral catheterization:a case report. J Korean Med Sci 2008;23:161-2. [11] Dangle PP, Tycast J, Vasquez E, Geary B, Chehval M. Suprapubic cystostomy:a bizarre complication of catheter migration causing ureteric obstruction. Can Urol Assoc J 2010;4:E127-8. [12] Hale N, Baugh D, Womack G. Mid-ureteral rupture:a rare complication of urethral catheterization. Urology 2012;80:e65-6. [13] Papacharalabous E, Ford M, Butler-Manuel S, Tailor A. Inadvertent insertion of a Foley's catheter through the orifice of a duplex ureter during catheterisation for laparotomy. Gynecol Surg 2011;8:99-101. [14] Adeyemo B, Makovitch S, Foo D. A peculiar complication of suprapubic catheterization:recurrent ureteral obstruction and hydronephrosis. J Spinal Cord Med 2013;36:166-9. [15] Baker KS, Dane B, Edelstein Y, Malhotra A, Gould E. Ureteral rupture from aberrant Foley catheter placement:a case report. J Radiol Case Rep 2013;7:33-40. [16] Modi PK, Salmasi AH, Perlmutter MA. Inadvertent foley catheterization of the ureter. Can J Urol 2014;21:7326-9. [17] Ishikawa T, Araki M, Hirata T, Watanabe M, Ebara S, Watanabe T, et al. A rare complication:misdirection of an indwelling urethral catheter into the ureter. Acta Med Okayama 2014;68:47-51. [18] Viswanatha RK, Moore CM, Thakar R. Intra-ureteric placement of a urinary catheter in the previously undiagnosed duplex ureter. Int Urogynecol J 2014;25:143-4.
Christopher Hartman, Nikhil Gupta, David Leavitt, David Hoenig, Zeph Okeke, Arthur Smith. Advances in percutaneous stone surgery[J]. Asian Journal of Urology, 2015, 2(1): 26
-32
.
