Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2023; 11(30): 7413-7417
Published online Oct 26, 2023. doi: 10.12998/wjcc.v11.i30.7413
Iatrogenic bladder neck rupture due to traumatic urethral catheterization: A case report
Ozgur Ekici, Ercüment Keskin, Fatih Kocoglu, Ali Seydi Bozkurt
Ozgur Ekici, Ercüment Keskin, Fatih Kocoglu, Ali Seydi Bozkurt, Department of Urology, Faculty of Medicine, Erzincan Binali Yıldırım University, Erzincan 24000, Turkey
Author contributions: Ekici O and Keskin E compiled the literature and data; Kocoglu F and Bozkurt AS drafted the paper and prepared the figure; Ekici O reviewed and revised the final version of the paper.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this case report.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ali Seydi Bozkurt, MD, Associate Professor, Department of Urology, Faculty of Medicine, Erzincan Binali Yıldırım University, Tekin Civas Street, Erzincan 24000, Turkey. draliseydi@gmail.com
Received: July 5, 2023
Peer-review started: July 5, 2023
First decision: August 9, 2023
Revised: August 9, 2023
Accepted: September 18, 2023
Article in press: September 18, 2023
Published online: October 26, 2023
Processing time: 111 Days and 20.2 Hours
Abstract
BACKGROUND

In this article, we present a case of iatrogenic bladder neck rupture due to catheter insertion in a 94-year-old comorbid male patient.

CASE SUMMARY

The patient, who had a urethral catheter inserted in the palliative service 3 d ago, was consulted because the catheter did not work. Because the fluid given to the bladder could not be recovered, computed tomography was performed, which revealed that the catheter had passed the bladder neck first into the retrovesical area then into the intraabdominal area. The appearance of the anterior urethra and verumontanum was normal at cystoscopy. However, extremely severe stenosis of the bladder neck, and perforated posterior wall of the urethral segment between the prostatic urethra and the bladder neck were observed. Internal urethrotomy was applied to the bladder neck with a urethrotome. An urethral catheter was sent over the guide wire into the bladder. The patient was followed in the palliative care service and the catheter was removed 7 d later. No extravasation was observed in the control urethrography.

CONCLUSION

Although catheter insertion is a simple and frequently performed procedure in hospitalized patients, it is necessary to avoid unnecessary extra-indication catheter insertion.

Keywords: Bladder neck rupture; Uretrhral catheterization; Iatrogenic; Extravasation; False route; Case report

Core Tip: False routes developed during urethral catheterization may lead to perforation of the urethra. In comorbid and elderly male patients, this may go so far as to impair the general condition of the patient. Unnecessary and off-label catheter insertion should be avoided and the catheter set should be made by experienced people. The case report that we presented is important in terms of exemplifying this situation.