Pediatric urethral catheter consultations: understanding driving factors.
OBJECTIVE
Pediatric urethral catheterization is often straightforward. However, it can be challenging and may require urological consultation. Possible critical factors are patient anatomy and comorbidities, and insertion technique. To better understand pediatric catheter consultations, we reviewed our experience.


METHODS
All pediatric catheter consultations between July 2009 and June 2012 were identified. A retrospective review was then performed, focusing on demographics, reasons for consultation and difficulty of catheter placement. The 4 categories of difficulty noted were easy, challenging, extremely difficult and could not be placed. Patients were excluded from analysis if catheter placement was not needed, the consultation was for a catheterizable stoma or they were status post urological surgery. Statistical analyses were performed to evaluate associations between patient factors and difficulty of placement.


RESULTS
A total of 93 consultations were identified, of which 57% were inpatient, 28% intraoperative and 15% other source. Of the inpatient consultations 75% were from an intensive care unit, the majority (80%) of which were for catheter placement, with the remainder for removal, nondraining catheter, trauma or other. After exclusions 65 patients remained, of whom 80% were male and 32% had a urological comorbidity. By difficulty level 69.2% of cases were easy, 15.4% were challenging, 9.2% were extremely difficult and 6.2% could not be placed. Location of consult, gender, urological comorbidity and history of prematurity were not significantly associated with difficult catheter placement.


CONCLUSIONS
Pediatric catheter consultations are largely straightforward. Comorbidities do not significantly impact catheter placement. Correct catheter technique may be more important than patient comorbidities, giving us a basis to shape catheter insertion training within pediatric hospitals.
Department of Urology, Division of Pediatric Urology, University of Michigan, Ann Arbor, Michigan.
Nina F
NF
Casanova
Department of Urology, Division of Pediatric Urology, University of Michigan, Ann Arbor, Michigan.
Chang
C
He
Department of Urology, Division of Pediatric Urology, University of Michigan, Ann Arbor, Michigan.
Kate H
KH
Kraft
Department of Urology, Division of Pediatric Urology, University of Michigan, Ann Arbor, Michigan.
Vesna
V
Ivancic
Department of Urology, Division of Pediatric Urology, University of Michigan, Ann Arbor, Michigan.
David A
DA
Bloom
Department of Urology, Division of Pediatric Urology, University of Michigan, Ann Arbor, Michigan.
John M
JM
Park
Department of Urology, Division of Pediatric Urology, University of Michigan, Ann Arbor, Michigan.
Julian
J
Wan
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012017:Referral and Consultation; D012189:Retrospective Studies; D014546:Urinary Catheterization / Q000295:instrumentation* / Q000592:standards*; D062885:Urinary Catheters; D055815:Young Adult
pediatrics; urethra; urinary catheterization