Evaluating the cost of iatrogenic urethral catheterisation injuries.

Abstract

Technique is vital to prevent urethral trauma during urethral catheterisation (UC). Education programmes are helpful but are not compulsory and safe UC remains operator dependent. Traumatic UC is associated with increased morbidity, length of stay, resource utilisation and surgical intervention. To determine the cost of iatrogenic urethral injuries managed in a tertiary referral centre over a 6-month period. A 6-month prospective study monitored iatrogenic urethral injuries secondary to traumatic UC. Included were referrals from district hospitals and inpatient consultations relating to urethral injury caused by traumatic UC. The added cost of management was estimated. Thirteen iatrogenic urethral injuries were recorded in 6months. Management included open surgery for a ruptured bladder (n=1), flexible cystourethroscopy (n=10), suprapubic catherisation (n=4), 3-way catheterisation (n=4) and catheter re-insertion under direct vision (n=6). The cost of acute management of these injuries was approximately €50,000 including theatre costs, ambulance transfer, hospital stay, procedural and equipment costs and short-term follow-up care. Iatrogenic injuries during UC represent a significant cost burden to the healthcare system. Training programmes should be compulsory for all healthcare professionals routinely involved in catheterisation procedures.