title: Evaluating the cost of iatrogenic urethral catheterisation injuries.
abstract: BACKGROUND
  Technique is vital to prevent urethral trauma during urethral catheterisation (UC). Education programmes are helpful but are not compulsory and safe UC remains operator dependent. Traumatic UC is associated with increased morbidity, length of stay, resource utilisation and surgical intervention.
  
  
  OBJECTIVE
  To determine the cost of iatrogenic urethral injuries managed in a tertiary referral centre over a 6-month period.
  
  
  METHODS
  A 6-month prospective study monitored iatrogenic urethral injuries secondary to traumatic UC. Included were referrals from district hospitals and inpatient consultations relating to urethral injury caused by traumatic UC. The added cost of management was estimated.
  
  
  RESULTS
  Thirteen iatrogenic urethral injuries were recorded in 6 months. Management included open surgery for a ruptured bladder (n = 1), flexible cystourethroscopy (n = 10), suprapubic catherisation (n = 4), 3-way catheterisation (n = 4) and catheter re-insertion under direct vision (n = 6). The cost of acute management of these injuries was approximately €50,000 including theatre costs, ambulance transfer, hospital stay, procedural and equipment costs and short-term follow-up care.
  
  
  CONCLUSIONS
  Iatrogenic injuries during UC represent a significant cost burden to the healthcare system. Training programmes should be compulsory for all healthcare professionals routinely involved in catheterisation procedures.
authors.affiliation: Department of Urology, Tallaght Hospital, Dublin 24, Ireland. nikitarb89@gmail.com.
authors.forename: N R
authors.initials: NR
authors.lastname: Bhatt
authors.affiliation: Department of Urology, Tallaght Hospital, Dublin 24, Ireland.
authors.forename: N F
authors.initials: NF
authors.lastname: Davis
authors.affiliation: Finance Department, Tallaght Hospital, Dublin 24, Ireland.
authors.forename: D
authors.initials: D
authors.lastname: Addie
authors.affiliation: Department of Urology, Tallaght Hospital, Dublin 24, Ireland.
authors.forename: R
authors.initials: R
authors.lastname: Flynn
authors.affiliation: Department of Urology, Tallaght Hospital, Dublin 24, Ireland.
authors.forename: T E D
authors.initials: TED
authors.lastname: McDermott
authors.affiliation: Department of Urology, Tallaght Hospital, Dublin 24, Ireland.
authors.forename: R P
authors.initials: RP
authors.lastname: Manecksha
authors.affiliation: Department of Urology, Tallaght Hospital, Dublin 24, Ireland.
authors.forename: J A
authors.initials: JA
authors.lastname: Thornhill
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000191:economics*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014546:Urinary Catheterization / Q000009:adverse effects* / Q000191:economics* / Q000379:methods
keywords: Catheter; Complications; Cost; Iatrogenic