Incidence, Cost, Complications and Clinical Outcomes of Iatrogenic Urethral Catheterization Injuries: A Prospective Multi-Institutional Study.
Data on urethral catheter related injuries are sparse. To highlight the dangers inherent in traumatic urethral catheterization we prospectively monitored the incidence, cost and clinical outcomes of urethral catheter related injuries.



This prospective study was performed during a 6-month period at 2 tertiary referral teaching hospitals. Recorded data included method and extent of urethral catheterization injury, setting and time of injury, number of catheterization attempts, urological management provided, additional bed days due to urethral injury and clinical outcomes after followup. The additional cost of managing urethral injuries was also calculated.



A total of 37 iatrogenic urethral injuries were recorded during the 6-month period. The incidence of traumatic urethral catheterization was 6.7 per 1,000 catheters inserted. Thirty (81%) patients sustained a complication Clavien-Dindo grade 2 or greater. The additional length of inpatient hospital stay was 9.4 ± 10 days (range 2 to 53). Of these patients 9 (24%) required an indwelling suprapubic catheter and 8 (21%) have an indwelling transurethral catheter. In addition, 9 (24%) are performing self-urethral dilation once weekly and 4 (11%) have required at least 1 urethral dilation due to persistent urethral stricture disease. The additional cost of managing iatrogenic urethral injuries was €335,377 ($371,790).



Iatrogenic urethral catheterization injuries represent a significant cost and cause of patient morbidity. Despite efforts to educate and train health care professionals on urethral catheterization insertion technique, iatrogenic urethral injuries will continue to occur unless urinary catheter safety mechanics are altered and improved.
Department of Urology, St. Vincent's University Hospital, Dublin, Ireland. Electronic address: nialldavis2001@yahoo.com.
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NF
Davis
Department of Urology, Tallaght Hospital, Dublin, Ireland.
M R
MR
Quinlan
Department of Urology, Tallaght Hospital, Dublin, Ireland.
N R
NR
Bhatt
Department of Urology, St. Vincent's University Hospital, Dublin, Ireland.
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C
Browne
Department of Urology, St. Vincent's University Hospital, Dublin, Ireland.
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MacCraith
Department of Urology, Tallaght Hospital, Dublin, Ireland.
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Manecksha
Centre for Applied Biomedical Engineering Research, Materials and Surface Science Institute, University of Limerick, Castletroy, Limerick, Ireland.
M T
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Walsh
Department of Urology, Tallaght Hospital, Dublin, Ireland.
J A
JA
Thornhill
Department of Urology, St. Vincent's University Hospital, Dublin, Ireland.
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Mulvin
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017048:Health Care Costs; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014521:Urethra / Q000293:injuries*; D014546:Urinary Catheterization / Q000009:adverse effects*; D062885:Urinary Catheters / Q000009:adverse effects*; D014947:Wounds and Injuries / Q000150:complications / Q000191:economics / Q000453:epidemiology
catheterization; iatrogenic disease; urethra; urinary catheter; wounds and injuries