Complications of Urinary Catheters
Too many unnecessary
urinary catheterizations are done and we need to work to reduce them.
Some people have even died from complications caused by urinary catheters.
Every patient should be informed about the risks of urinary catheters and
offered alternative procedures that are less invasive. For example, a bladder
scanner can easily measure the bladder volume. Check out "How
to Avoid Unnecessary Catheterizations" - Outpatient Surgery for
more information about how bladder scanners work and decrease the need for
urinary catheters. The bladder scanner reduces potential infection and also
the use of antibiotics. Bladder scanner also protects your modesty if you
are wearing underwear or shorts because only the abdomen has to be exposed.
Foley catheters are not appropriate as a treatment for incontinence.
It is best for the patient to make frequent trips to the restroom or use
a bedpan.
The elderly are at a higher risk of inappropriate catheterization because
they may be less likely to advocate for themselves. Elderly patients are
often less likely to question the catheter or may possibly not even have
the mental capacity to question it. That is a concern because the elderly
are more likely to have a bad outcome from a hospital-acquired infection
due to other comorbidities. (Source:
Catheter Conundrum: Reducing Unnecessary Placement)
What Are The Complications of Urinary Catheters
That Could Occur?
- Urinary tract infections - It is very
common for patients to get UTIs from catheters. Some infections can be
very deadly. For example, infections in people recovering from total joint
replacement surgeries can have particularly devastating consequences.
An infection caused by catheterization can travel to the prosthesis; if
the problem becomes severe enough, the patient's prosthesis must be removed.
A hospital-acquired UTI is often not a simple infection to treat because
the bacteria are more likely to be drug resistant. The patient may need
to be on powerful antibiotics that have their own set of risk factors
associated with them. For example, the elderly are at high risk of getting
C difficile,
bacterium that can cause symptoms ranging from diarrhea to life-threatening
inflammation of the colon.
- Cystitis - Cystitis
is inflammation of the bladder and is most frequently caused by bacteria
in the bladder due to a urinary tract infection, but can also be caused
by certain drugs, radiation therapy, chemotherapy and long-term use of
a urinary catheter. According to MayoClinic.com, symptoms of cystitis
may include a frequent urge to urinate; cloudy, blood-tinged or strong
smelling urine; feelings of pressure in the abdomen; or possibly a low-grade
fever.
- Urethral Injury - Urethral injury due
to trauma is a common complication associated with Foley catheters especially
if the catheter is inserted forcefully or roughly. A significant urethral
injury can even cause death. Check out a case
where a man bled to death from forceful urinary catheter. Also, check
out this other case
where a 35 year old man from Georgia sustained serious and permanent injuries
from an unnecessary urinary catheter that was inserted for surgery.
Male urinary catheterization is a common procedure but 10-30% result in urethral trauma, potentially requiring urological consult, endoscopy and complex procedures for catheter placement. Injuries may include mucosal laceration and corpus spongiosum disruption. The complex male anatomy, history of urethral stricture, and enlarged prostate can make Foley catheter placement challenging as the standard procedure is performed without urethral visualization. 10-30 percent is a high rate of injury.
- Blood Infection - Blood infection,
or sepsis, is a rare complication of bladder catheterization and is typically
only found in patients requiring long-term catheterization. When long-term
catheterization is combined with the necessity of using a larger catheter,
damage to the lining of the bladder can occur. Large catheters are not
as soft as smaller ones, and they are more likely to scrape or puncture
the lining of the bladder. Bacteria that gain access to the bladder via
the catheter then access the blood supply through the damaged tissue of
the bladder.
- Blood in the Urine and Latex Allergy - The use of a urinary catheter may also cause a small amount of blood in the urine. This blood is typically caused by irritation of the ureters and bladder by the catheter itself. Blood may also be present if there is an infection in the urinary tract. Urinary catheters are typically made of latex. Allergies or sensitivities to latex should be reported to the health care provider before a latex urinary catheter is placed to avoid complications. If the allergy or sensitivity to latex is discovered because of the use of the urinary catheter, redness, irritation, itching, blood in the urine as well as abdominal pain and discomfort may occur.
- Bacteriuria - Bacteriuria (bacteria
in the urine) usually occurs in most patients who have a catheter in place
for 2 to 10 days. A large number and a variety of types of organisms are
present in the periurethral area and in the distal part of the urethra
that may be introduced into the bladder at the time of catheter insertion..
(Source: Complications
- Indwelling Catheters - UroToday)
- Difficulty Urinating After Catheter Removal - After the urinary catheter is removed, some people have difficulty urinating.
- Narrowing of the urethra (this complication usually occurs in long term insertion due to scar tissue formation by the insertion of the catheter)
- Bladder injury (caused due to incorrect insertion of the catheter)
- Bladder stones
- Kidney stones and kidney damage
- Bladder Cancer - It can occur in some
patients with indwelling catheters for long periods of time (Source: Complications
- Indwelling Catheters - UroToday)
Other Related Articles:
Unnecessary
Urinary Catheterizations and Missing Informed Patient Consent
Why Consent For Urinary Catheters Should Be Mandatory By John H. Fisher
Female Urinary Catheterization
Sources:
How
to Avoid Unnecessary Catheterizations - Outpatient Surgery
Catheter
Conundrum: Reducing Unnecessary Placement