Catheter-induced Urethral Erosion
Catheter-induced Urethral Erosion
A 64-year-old man was referred to the authors' facility from an extended care facility. Physically, the patient was debilitated and had decreased range of motion among all extremities. An indwelling bladder catheter was present as treatment for chronic urinary incontinence. His medical history indicated that a condom catheter had previously been utilized for urinary drainage but discontinued due to catheter-induced erosion of the penile skin.
The indwelling bladder catheter, inserted one year prior to this admission, had never been changed. Examination of the perineal area revealed a complete erosion of the ventral surface of the glans, urethra, and penile skin up to the penoscrotal junction (see Figure 1). The catheter was removed and sent to the laboratory for culture and sensitivity. Results from both the catheter and urine cultures documented the presence of Pseudomonas aeruginosa. This infection, as per the sensitivity reports, was sensitive to ceftazidime, netlimycin, and imipenem. Antibiotic treatment was initiated. Due to the overall debilitated condition of this patient, no formal urethroplasty was performed.
(Enlarge Image)
Figure 1.
Photograph of the penis of a 64-year-old male with history of indwelling catheter for one year. There is complete erosion of the ventral surface of glans, penile skin, and urethra, up to the penoscrotal junction.
The patient underwent a urinary diversion procedure. Because of his limited dexterity, clean intermittent catheterization was not an option; thus, a suprapubic cystostomy was performed under local anesthesia. The patient made an uneventful recovery and was discharged back to the extended care facility on the fourth post-operative day.
Case Report
A 64-year-old man was referred to the authors' facility from an extended care facility. Physically, the patient was debilitated and had decreased range of motion among all extremities. An indwelling bladder catheter was present as treatment for chronic urinary incontinence. His medical history indicated that a condom catheter had previously been utilized for urinary drainage but discontinued due to catheter-induced erosion of the penile skin.
The indwelling bladder catheter, inserted one year prior to this admission, had never been changed. Examination of the perineal area revealed a complete erosion of the ventral surface of the glans, urethra, and penile skin up to the penoscrotal junction (see Figure 1). The catheter was removed and sent to the laboratory for culture and sensitivity. Results from both the catheter and urine cultures documented the presence of Pseudomonas aeruginosa. This infection, as per the sensitivity reports, was sensitive to ceftazidime, netlimycin, and imipenem. Antibiotic treatment was initiated. Due to the overall debilitated condition of this patient, no formal urethroplasty was performed.
(Enlarge Image)
Figure 1.
Photograph of the penis of a 64-year-old male with history of indwelling catheter for one year. There is complete erosion of the ventral surface of glans, penile skin, and urethra, up to the penoscrotal junction.
The patient underwent a urinary diversion procedure. Because of his limited dexterity, clean intermittent catheterization was not an option; thus, a suprapubic cystostomy was performed under local anesthesia. The patient made an uneventful recovery and was discharged back to the extended care facility on the fourth post-operative day.