Complications of urinary bladder catheters and preventive strategies
- Anthony J Schaeffer, MD
Anthony J Schaeffer, MD
- Herman L Kretschmer Professor
- Northwestern University Feinberg School of Medicine
Urinary bladder catheters are used for urinary drainage or as a means to collect urine for measurement. Many clinical situations are appropriate for the placement of indwelling urethral catheters (table 1), but too frequently they are used without proper indication or continued longer than needed . Daily evaluation of the ongoing need for the indwelling catheters with removal when no longer indicated is essential to reduce complications.
This topic will discuss the complications associated with urinary catheter use. The indications for placement, types, and the management of urinary catheters are discussed in detail elsewhere. (See "Placement and management of urinary bladder catheters in adults".)
Bacteriuria and urinary tract infection — The presence of bacteria in the urine is almost universal in patients with catheters in place for over one week. Rates vary depending upon the type of catheter and duration of use. The evaluation of bacteriuria and diagnosis of catheter-associated urinary tract infection is discussed in detail elsewhere. (See "Catheter-associated urinary tract infection in adults", section on 'Asymptomatic bacteriuria' and "Catheter-associated urinary tract infection in adults", section on 'Diagnosis'.)
Recurrent urinary tract infections as a result of chronic catheter use can lead to acute or chronic pyelonephritis, or bladder cancer. (See "Epidemiology and risk factors of urothelial (transitional cell) carcinoma of the bladder" and "Non-urothelial bladder cancer".)
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- GENERAL COMPLICATIONS
- Bacteriuria and urinary tract infection
- - Epididymitis
- Retained balloon fragments
- Bladder fistula
- Bladder perforation
- Bladder stone formation
- COMPLICATIONS SPECIFIC TO TYPE OF CATHETER
- Condom catheters
- - Pressure effects
- Urethral catheters
- - Effects of urethral trauma
- - Incontinence
- Suprapubic catheters
- PREVENTION OF COMPLICATIONS
- SUMMARY AND RECOMMENDATIONS