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Urethra Damage from Improper Catheterization
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Urethra Damage from Improper Catheterization

I am currently recovering from a trip to the ER because I was unable to Urinate.  The doctor at the ER attempted to force a foley catheter in after the nurse had problems.  He did not get the catheter in properly, and I ended up being sent by ambulance to a second hospital where they attempted to use a scope to place a catheter but were unable due to the large amount of damage and bleeding from the previous problem.  I now have a supra pubic catheter in place (almost 2 weeks now), which will remain in place for an additional 3 weeks.  I will then be going in and while under anesthesia at they will use the scope again to verify that the damage has healed and then remove the supra pubic catheter.  Whatever caused the original inability to urinate has now subsided, currently when I pass stool some urine does come out the penis now. Of course because of the damage to the urethra this is painful bloody and often pushes out blood clots.  The Urologist that is now handling my case has been vague with answers, possibly to protect the first doctor because of his mistake.
I am wondering if anyone else has had similar experience and if they could possibly tell me what possible long term problems could occur from this type of injury?
I have already asked my insurance to withhold payment on any bills from this situation until I have spoken to a lawyer.  I am not big on suing people, but I believe that I should at least not be liable for medical bills that were caused from a medical professionals mistake.
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489228_tn?1291535054
I am sorry you had such an ordeal.  As someone who has to catheterize on a regular basis I know how painful it can be when done roughly and in your case, with something preventing the catheter from going in I can only imagine how much more painful!

OK, I personally have had a problem with my bladder shutting down.
However because I have Interstitial cystitis and do my own bladder instills I have been trained and have the tools to self cath,  At one point we were going on a trip and they also trained me how to put in a Foley cath and take it out  in case I had to, which only happened once.  I am now on a med for the problem but occasionally have an issue still.  Before I learned to do my instills at home I used to have to go into the office for them.  I hated being cathed by someone else and some of the nurses were much rougher then the others!  

I know it is easier to do myself.  I also know sometimes when something in there will not relax even for me getting the catheter through that tight spot hurts and is more of s struggle,  Urinary retention can be serious if you can not cath.  I assume this is why they had to force the cath in.  My thought though is if it they were unable to get the cath in and even if the doctor was trying to force it in
the fact it didn't go tells me you had something blocking it.  Could be a urethral stricture could have even been a kidney stone etc.  I don't know but something was blocking the opening and they had to get the urine out!  I am sure this is why they want to do scope and see how things have healed etc. honestly even scar tissue etc I guess mainly for males can build up in there and cause problems.

My point is this could be why they are so vague right now they do not know what caused the initial problem and retention is a serious issue if they can not get a catheter in... the first doctor may have been trying to save you etc from having a scope etc.  since they sent you to another hospital my guess is they did not have a URO on call that could scope you there either....

I know it is frustrating, I am someone who has been sick now for 14 plus years because of a hospital mistake so believe me I understand!
However, I would encourage you to wait till they do scope you and find out what's up.  Urine coming out a little when you strain could just be being forced in small amounts past something still might not be enough for a catheter to get it etc.

If once they do that you still feel that the problem was from the first hospital etc. go to the hospital and ask to speak to there crisis customer service rep. or basically the one who handles complaints etc.  Most hospital have one since they would rather deal with issues the fight law suits!  My sister had a c-section and told the doctor that she was not numb and he did it anyway!!  Despite that she was told by an attorney just to be thankful she was alive and ok etc. now and basically it would cost a lot and not worth suing.  I know she took the route above and I think they gave her a small break on the cost like for the anesthesia etc. but they more importantly made the doctor apologize to her directly himself and it was put on his record there.

Just a thought as an alternative to getting an attorney etc. I do know if you do sue and ever have to go back to that hospital it is not good and the truth is docs are very cautious around a patient that has sued someone in the past too. Also get all the records from both hospitals and read them.  This will give you a better idea of what they were doing!

Again I am sorry you had to go through all of this and hope they correct the problem permanently.

Shelly






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647273_tn?1292094741
Hi,

It is quite possible to do damage while inserting a catheter. Due to having a neurogenic bladder I have had to self catherize myself on a daily basis. While I was in the hospital with a bad kidney infection and pneumonia in March of 2008, I noticed that I was passing gas through the penis. After a cystoscopy it was confirmed that I have a fistula (hole) between my prostate and rectum.
Eventhough I have good sensation in that area the urologist blames it on catherization stating that I must have caused the fistula while self catherization.

In the case of a Foley catheter it could be possible that the balloon was inflated without the catheter being completely inside the bladder. This most likely would have caused the damage. What caused your inability to urinate? It could be that this had prevented the catheter from going in.

If a mistake was made it will be difficult or impossible to get them to admit that this was caused due to their action.

I hope that this will work out OK for you. I most likely will need extensive surgery to repair the fistula.

All the best.

Ron
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647273_tn?1292094741
Hi,

I forgot to mention a few things.

I currently have a suprapubic catheter in since March of 2008. At times when I do have a bowel movement urine will be passed through the penis. When I was using self catherization I had to do it due to the fact that I could never fully empty my bladder.
With the suprapubic catheter in I have experienced less discomfort that with a Foley through the penile urethra. At times I have some leakage from the penis, which seems to go hand in hand with bladder spasms.

It might be in your best interest to get an opinion or consultation from a different urologist. This way it can be confirmed that damage has been done. This would be helpful should you have to hire an attorney. They can then use to second opinion against the medical professional who caused the damage.

I have had one occasion where a local doctor could not get the Foley in after I had tried it myself. I was sent by ambulance to take me to a urologist who put the Foley in using a sound. Personally I have a hard time believing that I could do damage by trying to insert a relatively soft catheter. My urologist thinks that the balloon was inflated prior to being completely inside the bladder. The force of the inflated balloon then does damage to the effected part of the urethra. In my case I'm not sure how it could have gone through the rectum. I have had a TURP in 1995 that might have weakened this area.

It is important to find out what caused your inability to urinate. If undetermined it would be possible to cause problems later on.

All the best.

Ron
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Avatar_m_tn
Yes the balloon was inflated without the catheter being in my bladder, they received blood believing that the blood was in my bladder they inflated the balloon.  When the SP catheter was placed there was no blood in my urine.  In my case I am wondering if the inability to urinate was possibly caused by Prostatitis, the antibiotics they gave me would have cured that.  If that was the case I will never know as  I don't believe they tested for it then.  By the time I got to the second hospital I had been given 4 doses of Demerol had not slept in over 24 hours, and between the drugs, pain, and lack of sleep I was having a hard time keeping up with what was happening.
In three weeks I will be going in for the follow up, to both get a scope to verify that my urethra has healed, that there is no urinary stricture at current, and have the SP catheter removed.  My biggest concerns are that they possibly damaged my uretheral spincter, or prostate with the catheter which could cause ongoing problems.  There is also a possibility of scar tissue from the damaged urethra causing a urinary stricture that I wouldn't not have had otherwise.
I may be over concerned about this, but I am only 32 and this is the first major medical issue I have had.  I hopefully have a long life ahead of me still, and having the quality of my life affected from this point onward is a serious concern.
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647273_tn?1292094741
I understand what you mean by not fully knowing as to what went on. I recently had my own incedent.

Having this happen can most definitely have done damage to the prost or urethra.
Since you state that pass urine while having a bowel movement indicates that you have control over the sphincter. This is a good sign. Having constantly loosing urine would be an indication of incontenence. I have this at times where I cannot control the sphincters.
After you get your SP removed you might experience some mild incontenece. This is caused by having constantly had an empty bladder as urine drained to the SP cath. This should return to normal soon. It would be worth to get this incident documented as this could pose problems later on.

I hope that you will be OK.

All the best.

Ron
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Avatar_m_tn
Well in case anyone is looking, as of last Monday, I had a follow surgery, they had to remove 3 strictures caused by scar tissue.  And have removed the SP catheter.  So far everything appears to be healing, and despite still having some pain from the surgery I am at least feeling better.
I still need to do more looking into whether or not the doctor that misplaced the cath should be responsible for paying my bills for most of this.  I still believe he should be, because if he had not done that I would have been better in a few days and not needed 6 weeks.  In addition to not needing a hospital stay, or follow up surgery.  There is no indication that I had anything beyond a UTI that was causing the original problem. A properly placed cath and antibiotics would have had me back to normal in a few days.
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647273_tn?1292094741
Hi,

I know what is like to have a UTI and I also know that catheterization during a UTI is not common. The only time that catheterization is required is when the bladder does not drain properly.

If the balloon was inflated prior to being inside the bladder than damage will result. The problem is that it is very difficult to prove that this took place. In my case the urologists were very quick in stating that I had put my catheter in inproperly. I think that I should have been able to feel that the catheter was not in the right place if this indeed was the case.

In your case I'd advise you to get your medical records from both hospitals and have the second hospital state what they discovered when you came in. If they stated that it was an inproper procedure than you have a good case to present.

All the best.

Ron
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2188022_tn?1338081997
I was admitted as a day-surgery patient to the Oxford Churchill Hospital (UK). I had an exploratory bowel examination under general anaesthetic. It is known that I always have the same side-effect (after a general anaesthetic) and that is - my urethra constricts the flow of urine to zero and I cannot urinate at all. Two nurses tried to catheterise me (3 times each) with a normal soft-type catheter. But every time they tried they hit a solid obstruction which hurt a lot - even though they were being very gentle with me. They then called a Registrar Urologist (Dr. O'Donaghue) and he tried to catheterise me and failed too - so that was 7 attempts -all of which hurt me a lot. He went away and came back about 30 seconds later with a much larger diameter sharp plastic 3-way catheter. He didn't speak to me or explain anything to me. He just squirted Instillagel into my penis, pulled my penis right down between my legs and thrust the catheter into me with brutal force and speed - and he failed again. The pain was eye-watering and before I had a chance to shout stop he did exactly the same again with even more brute force and speed. On this 9th attempt he had obviously "Stabbed" the catheter into my bladder because both urine and blood spurted out of my penis from around the outside of the catheter as well as heavy blood-clots and urine passing down the tube and into the bag. I eased myself off the bed so that the nurses could clear up the mess and I was bleading quite heavily onto the floor as well as being in terrific pain.. O'Donaghue said nothing, apart from mumbling something when I asked him to apologise, and he the turned around and walked away. I just could not believe what had happened. I did not know him and had never met him before - he was not part of my surgical team and he new nothing of my medical history! Now I find that I have a severe urethral stricture which distorts my penis to an "L" shape and prevents proper erections. It is still very very painful although I am urinating properly now without the use of the catheter - which was totally blocked with coagulated blood and had to be replaced after I was admitted as an emergency to Warwick Hospital at 7.00am the following morning. They had discharged me, from the Churchill Hospital at 7.00pm  with a catheter-bag, full of blood clots - because they said I was a day-surgery patient only! Can you believe that. I can assure you it is true and I am hyper-angry with them. How dare they treat me like that? I have complained to Sir Jonathan Michael who is CEO of the Oxford Universities Hospital group that includes the Churchill Hospital.
This O'Donaghue should be thrown out of the medical profession and I have reported him to the British Medical Council too.
I still just cannot believe how he acted - and I am still in pain with this urethral stricture 3 months later!
From my own knowledge of human anatomy I have to assume that he punctured a hole through my urethra and burst the catheter through the adjacent tissue and into my bladder through a new hole that he had formed with his brutal actions. By pulling my penis down between my legs he was not lining up my urethra in a straight line to my bladder There was quite a lot of blood coming out of my penis and he didn't even make any notes before he walked away. He was so reckless and uncaring - I find it hard to believe myself!
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Avatar_m_tn
While in Memorial Hermann hospital following AAA surgery, a nurse began inserting a Foley catheter, but did not wait for urine to flow before she inflated the ballon with Saline. It ruptured my uretha and began bleeding. After some screaming, a Urologist was called in "STAT". He deflated and removed the Foley.  This damaged the spincter muscle.
He properly installed another after chatising the nurse. He said the new Foley would help the rupture heal. Well, 8 yrs 11 months later, I have a bladder that has stretched to hold up to 2600cc of urine.
I have had to self-cath for all those years, because the muscle fibers that is called the external urinary sphincter in the uretha do not work properly. If I wait until the bladder is full, I get infections, take anti-biotics, but can pee on my own, but still have to self-cath to get it empty. I have ED and use Cialis.
I have been cathing three times a day to eliminate UTIs. But still have to take anti-biotics for ten days about every three months. My urologist wants to try the Interstim to stimulate the sacral nerves and possibly strengthen the muscles and allow me to empty my bladder whenever I want. I pray this works. I will try the external test next week. (Dec 2012).

(Memorial Hermann Doctors did not do the following. The catheter was not left in for 6-8 weeks and monitored) So the damages tissue would heal properly.
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Avatar_m_tn
Sounds like you are enjoying your free socialezed medicine. Good luck to you Obamaites--there is plenty of this coming your way.
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Avatar_m_tn
HI I JUST HAD A PROCEDUER DONEI HAD AN OBSTRUSTION FROM A MOTORCYCLE ACCIDENT SO I HAD SURGERY DONE AND THEY CATHERDIZED ME.WHEN THEY WENT UP A SIZE THE REPLACMENT CATHER WAS NOT FILLED UP ENOUGH WITH WATER AND THE CATHDER BALLON WAS PUSHED BACK DOWN UNTIL IT GOT STUCK AT THE END OF MY PENIS I WAS RUSHED TO THE HOSIPTAL AND HAD TO WAIT IN THE ER FOR 5 HRS UNTIL THEY SAW ME AND AT THAT TIME I HAD TO URNATE SO BAD AND THE PAIN WAS SO BAD I WAS SO UPSET AND IN PAIN WHEN IT WAS OVER AFTER I DIDNT TALK TO MY DR FOR AWHILE.SO WHEN MY DR FINALLY GOT BACK IN TOUCH WITH ME HE KNEW NOTHING ABOUT WHAT HAPPENED IN THE OFFICE BY HIS NURSES SO I DO KNOW WHAT YOU ARE GOING THROUGH AND I PRAY YOU RECOVER.
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Avatar_m_tn
Wow!!! After reading some of the HORROR story's on here it makes me feel like my issue isn't so bad. I went in to have a brain tumor removed in Aug. 2009 and thus needed a catheter. Coming out of the anesthesia I was also on some steroids for seizures. This all made me not myself and I became rather verbally abusive to the nurses and before they could remove my cath I tried to leave the hospital and that meant chewing through IV's and pulling out the still inflated cath. One of the nurses held my arm so I wouldn't pull out the cath and she succeeded. A while after I calmed down they removed it and it was the worst pain I had ever felt. I was so glad it was out! But when my bladder filled back up I simply could not urinate at all......even knowing that I would have to feel the cath go in I still could not urinate. They catheterized me 8 times over the course of a few days and it was so painful I NEVER want to go through it again.........NEVER! Finally on the 5th day I was able to urinate slightly and get discharged. For a good 6 months I was fine and I was so glad for every single urination due to the horrific experience I had just had. But shortly after the half year mark from the surgery.....I started having really painful urination's. It has continued for about 5 years now. The pain consist of a sharp "closing" feeling at the base of the penis near the prostate and the burning/pain is clearly felt at the tip as well. Leaking is very common and it can be uncomfortable for about 10 minutes until the burning and discomfort subside. I dread every sing urination now and there seems to be some correlation between how empty my bladder gets and the level of pain. The closer I get to an empty bladder the sharper the pain gets from the "closing door" in my UT. I am starting to buckle under the constant pain and discomfort and the main reason I have not done anything to remedy the problem is the fact that to find out what's wrong....I will have to relive the one thing I swore I would NEVER do again......It was that bad for me! If I can live like this for the rest of my life.....I may just do it and be miserable. If anyone reads this and has the same issue.....please let me know if you find the solution. Thank you ***@****
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