title: [Suprapubic cystostomy catheter knotting. Presentation of the first national case and review of the literature].
abstract: OBJECTIVE
  This study presents the first Spanish case of a spontaneous knot in the catheter of a suprapubic cystostomy and review the national and international literature.
  
  
  METHODS
  The 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.
  
  
  RESULTS
  Knotting 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.
  
  
  CONCLUSIONS
  The 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.
authors.affiliation: Urology Department. Denia Hospital, Denia, Alicante, Spain. promeropez@gmail.com
authors.forename: Pedro
authors.initials: P
authors.lastname: Romero Pérez
authors.forename: F Eduardo
authors.initials: FE
authors.lastname: Lapuerta Torres
authors.forename: Manuel
authors.initials: M
authors.lastname: Amat Cecilia
authors.forename: Francisco José
authors.initials: FJ
authors.lastname: Merenciano Cortina
authors.forename: Maria Esther
authors.initials: ME
authors.lastname: Gordo Flores
authors.forename: Jose Antonio
authors.initials: JA
authors.lastname: Navarro Antón
authors.forename: Roberto
authors.initials: R
authors.lastname: Ferrero
mesh_terms: D000230:Adenocarcinoma / Q000150:complications; D000369:Aged, 80 and over; D002114:Calcinosis; D003559:Cystostomy / Q000009:adverse effects*; D020878:Device Removal; D004868:Equipment Failure; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000150:complications; D062885:Urinary Catheters; D016055:Urinary Retention / Q000209:etiology