Hello anita6450,
When long term catheterization is needed, an indwelling Foley
catheter is usually used. To reduce infection, these catheters are
changed usually between the third and sixth week of placement, with 30
days being the average. Bladder perforation is not a common
complication, with infection, stones and irritation seen far more
often. Occasionally urethral perforation and trauma may occur. When an
indwelling Foley is correctly inserted and properly stabilized so as
not to irritate or become dislodged, risk of perforation is greatly
reduced.
http://www.chclibrary.org/micromed/00069700.html
Bladder perforation is more commonly seen during other procedures,
such as endoscopy, cystoscopy, biopsy, and prostate surgery.
?Success rates have varied from 18 percent to 77 percent, but
complications such as bladder perforation?
http://www.clevelandclinic.org/urology/news/incontinence/07-04.htm
?Perforation of the bladder during a bladder biopsy, cystolitholapaxy,
transurethral resection of the prostate (TURP), or transurethral
resection of a bladder tumor (TURBT) is not uncommon. Incidence of
bladder perforation is reportedly as high as 36% following bladder
biopsy.?
http://www.emedicine.com/med/byname/bladder-trauma.htm
?As with any invasive procedure, complications can occur.
Complications related to cystoscopy include, but are not limited to,
the following:
?infection
?bleeding
?urinary retention
?bladder perforation?
http://www.stjohnsmercy.org/healthinfo/test/urology/TP067.asp
You can see an illustration of a male with a Foley catheter placement
on this page. Look for the second little camera icon, and click
?Indwelling catheter? to the left of the camera icon:
http://my.webmd.com/hw/female_incontinence/zp1652.asp
Bladder perforation is rather rare, and not even listed as a risk or
complication on most sites:
?Trauma to the urethra and/or bladder may result from incorrect
insertion of the catheter. Repeated irritation to the urethra during
catheter insertion may cause scarring and/or stricture, or narrowing,
of the urethra. The catheter may introduce bacteria into the urethra
and bladder, resulting in urinary tract infection. UTI can cause fever
and inflammation of the bladder and urethra. Patients who practice
intermittent catheterization can reduce their risks for UTI by using
antiseptic techniques for insertion and catheter care.?
http://www.chclibrary.org/micromed/00069700.html
Complications of longterm catheterization
A.See Urinary Catheter associated Urinary Tract Infection
1.Urosepsis
2.Bacteriuria
a.Single intermittent catheterization: 20% of elderly
b.Bacteriuria occurs in most patients in 2-3 weeks
B.Chronic renal inflammation
C.Pyelonephritis
D.Nephrolithiasis
E.Cystolithiasis
http://www.fpnotebook.com/URO98.htm
Using a catheter increases the risk for:
?Damage to the urethra.
?Damage to the skin of the penis.
?Urinary tract infection
http://my.webmd.com/hw/female_incontinence/zp1652.asp
I was able to find few articles on actual bladder perforation from an
indwelling catheter. Here is what I did find:
From a case report by Drs.Shapiro, Soderdahl, and Stack:
?Complications associated with long-term indwelling catheters include
bladder tumors,7 fistula formation,8 bladder perforation,9 and
periurethral abscess.10 These complications may also result from
long-term retention of a Foley catheter fragment and would likely
result in morbidities similar to those previously mentioned.?
http://www.turner-white.com/pdf/hp_jun00_foley.pdf
?Spontaneous bladder rupture is a very rare condition. The majority of
the cases are due to long-term indwelling catheters, radiation, or
acute infravesical obstruction.?
http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ProduktNr=224282&Ausgabe=228713&ArtikelNr=66119&filename=66119.pdf
?It is important to note that Foley catheter clamping is not a benign
procedure. Potential risks include cystitis, pyelonephritis,
urosepsis, and bladder perforation. Thus, Foley catheter clamping is
not commonly employed except in those rare occasions where bladder
reconstruction is being contemplated. The clamping should be performed
under strict supervision by monitoring patient comfort and bladder
capacity. Coexisting urinary tract infections must be eradicated prior
to proceeding with this endeavor.?
http://www.cgmh.org.tw/intr/intr5/c6700/OBGYN/f/web/USI%202/
?If you are changing the catheter because the old one was plugged, a
large amount of urine may be in the person?s bladder. Never drain more
than 500 cc of urine at one time. Pinch the catheter for 5 minutes
before finishing. Emptying the bladder too fast can cause problems.?
http://lifecenter.ric.org/content/510/?topic=1&subtopic=300
Insertion of the catheter can rarely cause problems:
?The urethra or bladder can be damaged. Occasionally, the bladder wall
is punctured.?
With long term use the following may occur:
? The urethra can be damaged or scarred.
? A long-term inflammation or infection of the kidneys can develop.
? "Stones" made of mineral deposits can form inside the kidneys or
bladder, or on the catheter tip or balloon.
? The scrotum, prostate or nearby structures can become infected.
http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/31695.html
Additional Information:
?Indwelling catheters should only be used when
absolutely necessary and removed as soon as feasible. Strict
asepsis should be followed during insertion. An iodophor
preparation should be used to cleanse the perineal area and the
meatus prior to catheter insertion. Cleansing the meatus and
surrounding tissues with an iodophor preparation provides
effective action against most gram-positive and gram-negative
bacteria and fungi (Axnick & Yarbrough, 1984 [2]). The smallest
catheter that will ensure adequate drainage should be used. A
small catheter will minimize trauma to the urethra thus reducing
the risks of infection. The smallest balloon possible should be
used so as to minimize trauma to the bladder neck (Edwards,
Lock, Powell, & Jones, 1983 [8]). Large balloons may cause
tissue damage to the bladder neck. Once inserted, the catheter
should be secured to the anterior thigh so as to minimize
movement of the catheter and tension on the balloon thus
reducing the possibilities of infection and trauma.? This article
makes no mention of bladder perforation risk.
http://www.stti.iupui.edu/VirginiaHendersonLibrary/articles/030002.pdf
Alternative to indwelling catheters for some patients
http://tis-group.org/cath.html
http://www.findarticles.com/p/articles/mi_m0PHH/is_1996_March_15/ai_64974956/pg_23
I hope this has cleared things up for you. If any part of this answer
is unclear, please request an Answer Clarification, before rating.
This will enable me to assist you further, if possible.
Regards,
crabcakes
Search Terms
bladder perforation + indwelling Foley catheter
risks indwelling catheters |
