By the time a urologist is called, 37 percent of patients are injured.
Even the first attempt can cause injury.
Bleeding after blind catheter passage may be a superficial mucosal tear or a more serious injury. Did you notice the torn and flapping urethral mucosa? The urothelium is just 3 to 4 cell layer thick! Even a passage of a flexible cystoscope can cause a mucosal tear. This video is the first and second pass with a flexible scope.
By the sixth attempt, injuries can be significant.
By the time the urologist is called, 37 percent of patients had adverse events.
A prospective analysis of consultation for difficult urinary catheter insertion at tertiary care centres in Northern Alberta This study examines the condition of how a patient presents when a urologist is called. Excluded were all patients who were successfully placed prior to needing the urologist, including those placements made by a urologic nurse. Adverse events included: urosepsis, bladder perforation and urethral trauma. Significant urethral injury as a result of catheterization attempts occurred in 32 percent.