ABSTRACT
OBJECTIVE: This study presents the first Spanish case of a spontaneous knot in the catheter of a suprapubic cystostomy and review the national and international literature. METHODS: The case of an 87-year-old patient who was diagnosed with adenocarcinoma of the prostate is presented. A suprapubic vesical puncture for urinary retention was urgently performed in this patient because of the impossibility of urethral catheterisation. A spontaneous knot in the catheter was detected upon removal; the tightened knot could be removed by gentle and sustained traction without surgery. RESULTS: Knotting or calcification of the catheter was suspected when the catheter remained anchored in the bladder during a removal attempt 5 days after initial catheterisation. Plain pelvis x-ray was taken, but no calcification or knots were observed because the catheter was radiolucent. An ultrasound would have offered more information, but it was not requested. Gentle and sustained traction of the catheter reduced the knot size and allowed catheter removal without complications. Worldwide cases and national publications were reviewed. CONCLUSION: The formation of spontaneous or manipulation-induced knots in urinary cystostomy catheters is an extremely rare complication. The presented case is the first Spanish case of catheter knotting; it is only the 17th reported case worldwide.
Subject(s)
Cystostomy/adverse effects , Urinary Catheters , Adenocarcinoma/complications , Aged, 80 and over , Calcinosis , Device Removal , Equipment Failure , Humans , Male , Prostatic Neoplasms/complications , Urinary Retention/etiologyABSTRACT
OBJETIVO: Presentar el primer caso español de nudo espontáneo en un catéter de cistostomía suprapúbica y revisar la literatura nacional e internacional. MÉTODOS: Presentamos el caso de un paciente de 87 años, diagnosticado de adenocarcinoma de próstata, al que se le colocó de urgencia una punción vesical suprapúbica por retención urinaria ante la imposibilidad de sondaje uretral, produciéndose un nudo espontáneo en el catéter, detectado a su retirada, que se resolvió mediante tracción suave y sostenida del catéter, sin requerir cirugía. RESULTADOS: Se sospechó anudamiento o calcificación del catéter al intentar retirarlo a los 5 días de su colocación y permanecer éste anclado en la vejiga. Se realizó radiografía simple de pelvis no evidenciando calcificación ni nudo, al ser el catéter radiotransparente. La ecografía habría aportado más información pero no se solicitó. La tracción suave y mantenida del catéter apretó el nudo y permitió su retirada sin complicaciones. Revisamos los casos nacionales sobre nudos en catéteres urinarios y los casos mundiales publicados sobre nudos en catéteres de cistostomía suprapúbica. CONCLUSIÓN: La formación de nudos espontáneos en catéteres urinarios de cistostomía es una complicación extremadamente rara, pero mecánicamente posible. Nuestro caso, tras revisar la literatura es el primer caso español y el 17 mundial publicado(AU)
OBJECTIVE: This study presents the first Spanish case of a spontaneous knot in the catheter of a suprapubic cystostomy and review the national and international literature. METHODS: The case of an 87-year-old patient who was diagnosed with adenocarcinoma of the prostate is presented. A suprapubic vesical puncture for urinary retention was urgently performed in this patient because of the impossibility of urethral catheterisation. A spontaneous knot in the catheter was detected upon removal; the tightened knot could be removed by gentle and sustained traction without surgery. RESULTS: Knotting or calcification of the catheter was suspected when the catheter remained anchored in the bladder during a removal attempt 5 days after initial catheterisation. Plain pelvis x-ray was taken, but no calcification or knots were observed because the catheter was radiolucent. An ultrasound would have offered more information, but it was not requested. Gentle and sustained traction of the catheter reduced the knot size and allowed catheter removal without complications. Worldwide cases and national publications were reviewed. CONCLUSION: The formation of spontaneous or manipulation-induced knots in urinary cystostomy catheters is an extremely rare complication. The presented case is the first Spanish case of catheter knotting; it is only the 17th reported case worldwide(AU)
