• Pedro Romero Pérez, F Eduardo Lapuerta Torres, Manuel Amat Cecilia, Francisco José Merenciano Cortina, Maria Esther Gordo Flores, Jose Antonio Navarro Antón, and Roberto Ferrero.
• Urology Department. Denia Hospital, Denia, Alicante, Spain. promeropez@gmail.com
• Arch. Esp. Urol. 2013 Mar 1; 66 (2): 221-30.

ObjectiveThis study presents the first Spanish case of a spontaneous knot in the catheter of a suprapubic cystostomy and review the national and international literature.MethodsThe 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.ResultsKnotting 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.ConclusionThe 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.

16 keywords...

hide…