Abstract
We report a case of unilateral hydronephrosis following urethral catheterization in a patient with T6 complete paraplegia at the Physical Medicine and Rehabilitation Department in a tertiary care teaching hospital, India. Diagnosis was established by an abdominal ultrasound. The misplaced catheter tip was withdrawn from the ureteric orifice and hydronephrosis was resolved. Foley's catheterization, a widely practiced clinical procedure, is not without its attendant risks of an inadvertent placement in the ureter leading to transient hydronephrosis. Inadequate drainage through a catheter should thus alert one to this potentially hazardous complication that can be diagnosed by an early ultrasound. This complication can be avoided by gently tugging on the catheter after inflating the catheter bulb.
Highlights
Several methods are described in the literature for the management of acute and chronic neuropathic bladders[1,2,3,4]
We report a rare case of hydroureteronephrosis produced by the placement of the Foley catheter tip into the right ureter in a paraplegic patient during urethral catheterization
The inadvertent placement of a urethral catheter into the ureter through a patulous vesicoureteric orifice has been reported in the literature
Summary
Several methods are described in the literature for the management of acute and chronic neuropathic bladders[1,2,3,4]. Clean intermittent catheterization (CIC) is the most acceptable mode of early urologic management of a patient with acute spinal cord injury[5], it is a common clinical practice to catheterize the bladder following acute spinal cord injury and is occasionally performed as a medical emergency for urinary retention. Rare complications reported in the literature include intravesical knot of the Foley catheter and rupture of the bladder or urethra[6,7,8,9]. Acute hydronephrosis following neuropathic bladder is managed by providing continuous bladder drainage using an indwelling urethral catheter[10]. We report a rare case of hydroureteronephrosis produced by the placement of the Foley catheter tip into the right ureter in a paraplegic patient during urethral catheterization
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