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Complications of Urinary Catheters

Too many unnecessary urinary catheterizations are done and we need to work to reduce them. Some people have even died from complications caused by urinary catheters. Every patient should be informed about the risks of urinary catheters and offered alternative procedures that are less invasive. For example, a bladder scanner can easily measure the bladder volume. Check out "How to Avoid Unnecessary Catheterizations" - Outpatient Surgery for more information about how bladder scanners work and decrease the need for urinary catheters. The bladder scanner reduces potential infection and also the use of antibiotics. Bladder scanner also protects your modesty if you are wearing underwear or shorts because only the abdomen has to be exposed.

Foley catheters are not appropriate as a treatment for incontinence. It is best for the patient to make frequent trips to the restroom or use a bedpan.

The elderly are at a higher risk of inappropriate catheterization because they may be less likely to advocate for themselves. Elderly patients are often less likely to question the catheter or may possibly not even have the mental capacity to question it. That is a concern because the elderly are more likely to have a bad outcome from a hospital-acquired infection due to other comorbidities. (Source: Catheter Conundrum: Reducing Unnecessary Placement)

What Are The Complications of Urinary Catheters That Could Occur?

  • Urinary tract infections - It is very common for patients to get UTIs from catheters. Some infections can be very deadly. For example, infections in people recovering from total joint replacement surgeries can have particularly devastating consequences. An infection caused by catheterization can travel to the prosthesis; if the problem becomes severe enough, the patient's prosthesis must be removed. A hospital-acquired UTI is often not a simple infection to treat because the bacteria are more likely to be drug resistant. The patient may need to be on powerful antibiotics that have their own set of risk factors associated with them. For example, the elderly are at high risk of getting C difficile, bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon.

  • Cystitis - Cystitis is inflammation of the bladder and is most frequently caused by bacteria in the bladder due to a urinary tract infection, but can also be caused by certain drugs, radiation therapy, chemotherapy and long-term use of a urinary catheter. According to MayoClinic.com, symptoms of cystitis may include a frequent urge to urinate; cloudy, blood-tinged or strong smelling urine; feelings of pressure in the abdomen; or possibly a low-grade fever. (Source: Urinary Catheter Complications | LIVESTRONG.COM)

  • Urethral Injury - Urethral injury due to trauma is a common complication associated with Foley catheters especially if the catheter is inserted forcefully or roughly. A significant urethral injury can even cause death.

    Male urinary catheterization is a common procedure but 10-30% result in urethral trauma, potentially requiring urological consult, endoscopy and complex procedures for catheter placement. Injuries may include mucosal laceration and corpus spongiosum disruption. The complex male anatomy, history of urethral stricture, and enlarged prostate can make Foley catheter placement challenging as the standard procedure is performed without urethral visualization. (Source: PercuVision) 10-30 percent is a high rate of injury.

  • Blood Infection - Blood infection, or sepsis, is a rare complication of bladder catheterization and is typically only found in patients requiring long-term catheterization. When long-term catheterization is combined with the necessity of using a larger catheter, damage to the lining of the bladder can occur. Large catheters are not as soft as smaller ones, and they are more likely to scrape or puncture the lining of the bladder. Bacteria that gain access to the bladder via the catheter then access the blood supply through the damaged tissue of the bladder. (Source: Complications of Foley Catheters | LIVESTRONG.COM )

  • Blood in the Urine and Latex Allergy - The use of a urinary catheter may also cause a small amount of blood in the urine. This blood is typically caused by irritation of the ureters and bladder by the catheter itself. Blood may also be present if there is an infection in the urinary tract. Urinary catheters are typically made of latex. Allergies or sensitivities to latex should be reported to the health care provider before a latex urinary catheter is placed to avoid complications. If the allergy or sensitivity to latex is discovered because of the use of the urinary catheter, redness, irritation, itching, blood in the urine as well as abdominal pain and discomfort may occur. (Source: Urinary Catheter Complications | LIVESTRONG.COM)
  • Bacteriuria - Bacteriuria (bacteria in the urine) usually occurs in most patients who have a catheter in place for 2 to 10 days. A large number and a variety of types of organisms are present in the periurethral area and in the distal part of the urethra that may be introduced into the bladder at the time of catheter insertion.. (Source: Complications - Indwelling Catheters - UroToday)

  • Difficulty Urinating After Catheter Removal - After the urinary catheter is removed, some people have difficulty urinating.
  • Narrowing of the urethra (this complication usually occurs in long term insertion due to scar tissue formation by the insertion of the catheter)
  • Bladder injury (caused due to incorrect insertion of the catheter)
  • Bladder stones

  • Kidney stones and kidney damage

  • Bladder Cancer - It can occur in some patients with indwelling catheters for long periods of time (Source: Complications - Indwelling Catheters - UroToday)

     

Other Related Articles:

Unnecessary Urinary Catheterizations and Missing Informed Patient Consent

Why Consent For Urinary Catheters Should Be Mandatory By John H. Fisher

Female Urinary Catheterization

Male Urinary Catheterization

Sources:

How to Avoid Unnecessary Catheterizations - Outpatient Surgery

Catheter Conundrum: Reducing Unnecessary Placement

Urinary Catheter Complications | LIVESTRONG.COM

Complications Of Foley Catheters | LIVESTRONG.COM

Incidence of Foley Catheter Related Urethral Injury in a Tertiary Referral Center

Risks associated with Urinary Catheterisation

What is a Foley Catheter?

C. difficile - Mayo Clinic

Complications - Indwelling Catheters

 
     
   
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