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BERKELEY, CA (UroToday.com) - The Minneapolis Veterans Affairs Medical Center had a dedicated catheter nurse prospectively review the medical records of inpatients with Foley catheters. The study was a 16-month prospective surveillance of indwelling urinary catheter-associated complications in hospitalized veterans. The daily surveillance included Foley catheter related bacteria and trauma. During 6,513 surveyed Foley catheter days, urinalysis/urine culture was done in 407 patients, identifying 116 possible UTIs or 1.8% of Foley catheter days of which only 21, or 18%, involved clinical symptoms. The remaining 95 asymptomatic bacteriuria episodes accounted for 39 (70%) of 56 antimicrobial-treated possible UTIs.
The authors identified other catheter-related problems including 100 instances of GU trauma (1.5% of device days) with at least 1/3 of these leading to interventions such as cystoscopy. Other catheter-related problems included pain, gross hematuria, incidentally noted catheter migration, and overt mechanical trauma. Trauma events were characterized by injury type and resulting interventions. Categories include isolated hematuria, creation of false passage, accidental removal with balloon inflated, or misplacement of the Foley catheter, and ridging caused by an incompletely retracted catheter balloon at time of catheter removal.
The authors' analysis indicated that symptomatic UTIs only accounted for 0.3% of Foley catheter days, while catheter-related trauma requiring intervention was more common, accounting for 0.5% of Foley catheter days. This is article addresses other catheter-related problems, specifically GU trauma related to an indwelling catheter, something not well-documented in the medical literature but well-known in clinical practice.
Leuck AM, Wright D, Ellingson L, Kraemer L, Kuskowski MA, Johnson JR
Journal Citation: J Urol. 2012 May;187(5):1662-6