Penile Skin And Anterior Urethral Destruction Due To Chronic Indwelling Urinary Catheters

摘要

Permanent urethral catheterization is a predisposing factor for urinary tract infection. They need to be followed up and cared carefully. Patients with permanent urethral catheter should be followed up carefully regarding to urinary tract infections and urethral damage secondary to catheters. We are presenting a 83-year-old male patient with an enormous urethral destruction due to long-term catheterization. Introduction The two most frequent indications for chronic indwelling urinary catheters are urinary incontinence and bladder outlet obstruction (1). Although they relief the patient’s urinary symptoms, these catheters can be dangerous devices in chronicle usage. They have many complications such as urethral bleeding (a marker of mucosal trauma, cracking, or ulceration), urinary trauma, obstruction, infection, renal damage, and mortality (1, 2). Urethral destruction is a rare complication of chronic catheterization. It is most common in elderly people together with urinary infection and chronic disease (3). Tear of ventral penile skin and complete anterior urethral erosion are late and rare complications occurring after infection (3).Herein, we are presenting a case of penile skin and anterior urethral destruction due to chronic indwelling urinary catheters. Case Report A 83-year-old bedridden male patient with long-term catheterization for four years due to chronic urinary retention presented to our emergency department complaining of respiratory distress and complete destruction of the penile urethra and ventral penile skin. He was admitted to the intensive care unit due to respiratory failure and entubated. The patient had a history of hydrocephaly since 1997 and his cooperation was very bad for three years. Urethral catheter of the patient had changed a month ago at the last time. His medical history was unremarkable and had no chronic disease except hydrocephaly. On inspection, a 7 cm length area of destruction on the ventral aspect of the distal penile shaft, skin and urethra was completely destructive up to the penoscrotal junction. The urethral mucosa exposed along the length of the destruction area (Figure-1).