title: Efficacy of urethral catheterisation with a hydrophilic guidewire in patients with urethral trauma for treating acute urinary bladder retention after failed attempt at blind catheterisation.
abstract: OBJECTIVE
  To evaluate the efficacy of urethral catheterisation using a hydrophilic guidewire under fluoroscopic guidance in patients with urethral trauma after a failed attempt at blind catheterisation.
  
  
  METHODS
  A diagnosis of urethral trauma was made in 39 cases in 38 men. Patients ranged in age from 41 to 85 years (mean age, 60 years). Causes of the urethral injuries were iatrogenic urethral injury during catheter placement (n = 18), traumatic self-removal of a catheter (n = 12), straddle injuries (n = 6) and motor vehicle accidents (n = 3). All patients underwent failed blind urethral catheterisation. After urethrography, we attempted to insert a hydrophilic guidewire through the urethra into the urinary bladder, and then to place a 3-way balloon retention urethral catheter into the bladder guided by prior passage of the guidewire under fluoroscopy.
  
  
  RESULTS
  Of 39 attempts of inserting the urethral catheter into the urinary bladder, 34 (87.2%) were successful. Of 5 failures (12.8%), 2 were American Association for the Surgery of Trauma (AAST) urethral injury type 3 and 3 were type 4/5. Among these, there were 3 cases of pseudolumen formation.
  
  
  CONCLUSIONS
  Hydrophilic guidewire-assisted urethral catheterisation in patients with urethral trauma is a safe, simple technique for relieving acute bladder retention after a failed attempt at blind catheterisation.
  
  
  CONCLUSIONS
  Hydrophilic guidewire-assisted urethral catheterisation is useful following failed blind catheterisation. Immediate management of urethral injury is important to reduce morbidity. Hydrophilic guidewire-assisted urethral catheterisation can be applied immediately after diagnostic urethrography.
authors.affiliation: Department of Radiology, Soonchunhyang University Hospital Bucheon, 1174, Jungdong, Wonmigu, Bucheon, 420-767, Republic of Korea.
authors.forename: Sun Hye
authors.initials: SH
authors.lastname: Jeong
authors.forename: Seong Jin
authors.initials: SJ
authors.lastname: Park
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Kim
mesh_terms: D000208:Acute Disease; D000328:Adult; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D057928:Intermittent Urethral Catheterization / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome; D014521:Urethra / Q000000981:diagnostic imaging* / Q000293:injuries*; D016055:Urinary Retention / Q000000981:diagnostic imaging* / Q000628:therapy*