BERKELEY, CA (UroToday.com) - This article is about a case study of a 63-year-old, male resident of a local nursing facility in California, who developed urethral erosion, a common urethral complication with long-term indwelling urinary catheterization (IUC).
Additional complications seen with male urethral catheterization include ventral penile erosion, meatal erosion, and necrosis of the adjunct tissues. The patient presented to the hospital because of spiking fevers and possible infection. A physical examination revealed an unsecured IUC with an unnatural opening in his groin. On physical examination, it was determined that the catheter was inserted in an unnatural opening in his groin, just medial to the penile shaft. Further inspection revealed that the IUC had completely eroded through the urethra, and the lateral ventral skin of the penis at the pen scrotal junction. The author notes that one of the causes of urethral erosion is an unsecured catheter. Nursing home staff inspected every patient with an IUC in their 100-bed hospital and determined that only 34% had IUCs and only 18% had secured catheters. The author notes that the urethral erosion is well known but is unstudied in the complication of long-term urinary catheters, although this is in patients with long-term IUCs who are seen in urology practices. Urethral-erosion prevention measures include securing the IUC to the upper thigh, or to the abdomen in men, and removing the IUC, providing what the author calls a “catheter holiday.” If the patient has incomplete bladder emptying, intermittent catheterization can be performed.
Securing an IUC is simple and inexpensive, and the CDC, evidence-based guideline on prevention of CAUTIS recommends it.
J Wound Ostomy Continence Nurs. 2011;38(5):581-3.
doi: http://dx.doi.org/10.1097/WON.0b013e31822b3280
PubMed Abstract
PMID: 21915017
