Severe Indwelling Urinary Catheter-Associated Urethral Erosion in Four Elderly Men

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Start Page: 
36
End Page: 
39
Author(s): 
Mary Ann Bell, PhD, CNP, CWS

Index: Ostomy Wound Management 2010;56(12):36–39.

Key Words: urinary catheters , silicone, complication, urethral erosion, pressure

Abstract

  Medical devices often are overlooked as a potential cause of pressure ulcers. Indwelling urinary catheters have been described as a cause of urethral erosion. In men, the resultant partial-thickness or full-thickness wound can involve a small area of the glans penis or cleave the glans or penile shaft, requiring reconstructive surgery or urinary diversion. During a 3-month period, four elderly men, all residing in one unit of a long-term care facility, were referred to the wound specialist for erosive urethral injuries. All were observed to have a history of improper securement of a rigid style silicone catheter. As part of creating a latex-free environment, the facility had recently replaced the (softer) latex-containing catheters with new silicone catheters. In addition to providing meticulous catheter care and comfort measures for the patients, all securement procedures were reviewed and different silicone catheters were evaluated for their potential to cause pressure ulcers. This case series highlights the importance of careful evaluation of catheter materials and securement devices before selecting them for widespread patient use and emphasizes the need for research focused on catheter composition and pressure injury risk.

Potential Conflicts of Interest: none disclosed

  Incontinence rates are high among older patients and incontinence remains the primary reason for admission to long-term care (LTC) facilities.1 Incontinence increases the risk for perineal dermatitis, pressure ulcers, hip fractures, and falls.



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