title: How to manage acute urethral false passage due to intermittent catheterization in spinal cord injured patients who refused insertion of an indwelling catheter.
abstract: OBJECTIVE
  Acute urethral false passage is an important complication of clean intermittent catheterization in spinal cord injured patients. Temporary urethral stenting with an indwelling catheter is generally an excellent conventional therapeutic option to treat patients with acute false passage. However, how can acute false passage be managed in a patient who refuses insertion of an indwelling catheter?
  
  
  METHODS
  For 3 years 5 male patients with acute urethral false passage due to catheterization refused urethral stenting because indwelling catheter insertion would prevent sexual intercourse. We placed a nitinol prostatic stent successfully in the false urethral passage in all 5 patients. The stents were left in place for 3 to 6 months.
  
  
  RESULTS
  The stent migrated in 1 patient and it was replaced. During a retention period of 3 to 6 months all patients continued clean intermittent catheterization without any difficulty and achieved sexual intercourse. On urethral cystoscopy we observed that all false passages disappeared without a gross tissue reaction. The stents were then removed without any complications. During a mean followup of 11.8 months (range 4 to 25) none of these patients had another false passage. All continued to perform clean intermittent catheterization without any further difficulty.
  
  
  CONCLUSIONS
  Temporary placement of a removable endourethral stent is a safe and effective method for managing acute urethral false passage in patients on clean intermittent catheterization who refuse insertion of an indwelling catheter. This approach makes further clean intermittent catheterization possible and improves patient quality of life.
authors.affiliation: Division of Urology, Physical Therapy and Rehabilitation Center of Turkish Armed Forces, Ankara, Turkey.
authors.forename: Adil
authors.initials: A
authors.lastname: Gökalp
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yildirim
authors.forename: Emin
authors.initials: E
authors.lastname: Aydur
authors.forename: Salim
authors.initials: S
authors.lastname: Göktepe
authors.forename: Seref
authors.initials: S
authors.lastname: Başal
authors.forename: Kamil
authors.initials: K
authors.lastname: Yazicioğlu
mesh_terms: D000208:Acute Disease; D000328:Adult; D006801:Humans; D008297:Male; D013119:Spinal Cord Injuries / Q000150:complications*; D015607:Stents; D014521:Urethra / Q000293:injuries; D014546:Urinary Catheterization / Q000009:adverse effects*; D016055:Urinary Retention / Q000209:etiology / Q000628:therapy*