Catheter-induced Urethral Erosion
Indwelling bladder catheters are indicated when a patient requires voiding assistance (Gray, 2008). Long-term use of these catheters has been correlated with significant morbidity (Kunin et al., 1992). All of these cases require proper nursing care to prevent possible complications. Catheter-induced erosion of the urethra and penile skin is rare; however, it is a possible complication among patients with long-term indwelling catheters when care is neglected. When catheter tubing is adhered to the inner thigh, the catheter may act as a bowstring and cut through the urethra and skin. This is particularly a risk in the presence of an erect penis (Vaidyanathan, Soni, Hughes, Singh, & Oo, 2010). The associated infection can also act as an additive factor, hastening the erosion of the urethra and surrounding skin.
This devastating complication can be avoided by assuring that when the catheter is adhered to the thigh, there is free movement. Care should be taken to avoid any tension on the catheter or penis. Surgical reconstruction of the urethra, difficult under the best of circumstances, is often not feasible in the presence of the multiple co-morbidities, which renders extensive reparative maneuvers impossible (Casey et al., 2008; Gokhan, Kahraman, Kemal, & Semih, 2006; Vaidyanathan et al., 2010).
Clinical Implications
Indwelling bladder catheters are indicated when a patient requires voiding assistance (Gray, 2008). Long-term use of these catheters has been correlated with significant morbidity (Kunin et al., 1992). All of these cases require proper nursing care to prevent possible complications. Catheter-induced erosion of the urethra and penile skin is rare; however, it is a possible complication among patients with long-term indwelling catheters when care is neglected. When catheter tubing is adhered to the inner thigh, the catheter may act as a bowstring and cut through the urethra and skin. This is particularly a risk in the presence of an erect penis (Vaidyanathan, Soni, Hughes, Singh, & Oo, 2010). The associated infection can also act as an additive factor, hastening the erosion of the urethra and surrounding skin.
This devastating complication can be avoided by assuring that when the catheter is adhered to the thigh, there is free movement. Care should be taken to avoid any tension on the catheter or penis. Surgical reconstruction of the urethra, difficult under the best of circumstances, is often not feasible in the presence of the multiple co-morbidities, which renders extensive reparative maneuvers impossible (Casey et al., 2008; Gokhan, Kahraman, Kemal, & Semih, 2006; Vaidyanathan et al., 2010).
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