title: Impossible bladder catheter removal. What can we do?
abstract: OBJECTIVE
  The inability to remove a bladder catheter due to impossible balloon removal is a situation with controversial management; there are no action guidelines  and it is limited to individual experience in most cases. In this article, we review the techniques described for removing a urethral catheter and we share our experience  with one case.
  
  
  METHODS
  A 70-year-old male with permanent bladder catheter was referred to the emergency department due to an inability to deflate the self-retaining  balloon during routine change in his health centre.
  
  
  RESULTS
  After unsuccessfully trying to puncture the balloon through the inflation channel previously cut above the valve, we punctured it via the suprapubic route  under ultrasound guidance with a biopsy needle. Using this technique, we managed to rupture the balloon without free fragments, enabling the catheter to be changed without  incident.
  
  
  CONCLUSIONS
  There are various techniques for approaching this situation, the knowledge of which enables the urologist to resolve the problem by adapting to patient's  characteristics and available resources. Suprapubic puncture of the self-retaining balloon is an easily reproducible technique with minimal complications and a lower  rate of free fragments.
authors.affiliation: Department of Urology, Hospital General Universitario Gregorio Marañón, Madrid, Spain. robersescu@hotmail.com
authors.forename: R
authors.initials: R
authors.lastname: Molina Escudero
authors.forename: F
authors.initials: F
authors.lastname: Herranz Amo
authors.forename: E
authors.initials: E
authors.lastname: Lledo Garcia
authors.forename: A
authors.initials: A
authors.lastname: Husillos Alonso
authors.forename: G
authors.initials: G
authors.lastname: Ogaya Pinies
authors.forename: E
authors.initials: E
authors.lastname: Lopez Lopez
authors.forename: A
authors.initials: A
authors.lastname: Madrid Vallenilla
authors.forename: A
authors.initials: A
authors.lastname: Poza García
authors.forename: C
authors.initials: C
authors.lastname: Hernandez Fernandez
mesh_terms: D000368:Aged; D001707:Biopsy, Needle / Q000295:instrumentation; D057785:Catheters; D020878:Device Removal / Q000379:methods*; D006801:Humans; D008297:Male; D018084:Ultrasonography, Interventional / Q000379:methods*; D014546:Urinary Catheterization / Q000295:instrumentation*