title: Patterns of urinary catheter consults in a tertiary care hospital.
abstract: BACKGROUND
  We reviewed the consultation patterns for difficult urethral catheter placement in tertiary care hospitals and developed a treatment algorithm for this common request.
  
  
  METHODS
  We identified all urethral catheter consults obtained by urology residents at three tertiary care hospitals from October 2009 through October 2010. Only consults for inability to place urethral catheter by the referring team were included; hematuria or clot retention were excluded. Patient age, date of consultation, consulting service, prior urologic history, initial number of attempts, and final outcome were recorded.
  
  
  RESULTS
  Eighty-one consults were recorded. Seventy-seven (96%) were male; the median age was 65 years. The most common consulting services were internal medicine (35%), intraoperative consults (17%), and the intensive care unit (17%). In 90% of cases, an initial attempt at catheter placement was attempted; 62% of these were made by nurses. Over half of patients had known urologic pathology. In 70% of cases, successful placement without other adjuncts was achieved by the urology resident. Twenty percent of patients required cystoscopic manipulation; nine percent required suprapubic tube placement.
  
  
  CONCLUSIONS
  Catheterization was achieved without adjunct procedures in the majority of consults. These results support an algorithm in which all patients without a prior history of lower urinary tract pathology should undergo an initial placement attempt by the primary service physician. They also underscore the need for educational efforts to improve non-urologists' comfort level with placement of a standard Foley or Coudé catheter.
authors: Stanford University School of Medicine, Stanford, California, USA.
authors: Jen-Jane
authors: JJ
authors: Liu
authors: David P
authors: DP
authors: Guo
authors: Harcharan
authors: H
authors: Gill
mesh_terms: D000368:Aged; D000465:Algorithms; D002983:Clinical Competence; D003422:Critical Care / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000706:statistics & numerical data; D007396:Internship and Residency; D007430:Intraoperative Care / Q000706:statistics & numerical data; D008297:Male; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D062606:Tertiary Care Centers; D014546:Urinary Catheterization / Q000379:methods / Q000706:statistics & numerical data*; D014570:Urologic Diseases / Q000150:complications; D014572:Urology / Q000193:education / Q000706:statistics & numerical data*