2026-03-16
Improper catheterization procedures may lead to some complications. This article describes the causes and clinical manifestations of these complications, and proposes prevention and treatment measures, hoping to be helpful to patients.
VI. Formation of pseudo-urethral channels
1. Causes of the incident
This condition is more common in patients with spinal cord injuries. It occurs when a urinary catheter is repeatedly and intermittently inserted, damaging the membranous part of the urethra.
2. Clinical manifestations
Pain in the urethra, bleeding from the urethral opening. Urethral examination revealed the formation of a pseudo-channel.
3. Prevention and Treatment
3.1 When inserting the urinary catheter, the procedure should be slow and gentle. It is necessary to understand the resistance at the sphincter area. When the front end of the catheter reaches this point, pause for a moment and then continue insertion. If necessary, 2% lidocaine can be injected into the urethra.
3.2 Strictly control the interval time. The frequency of catheterization is 4-6 hours once, and no more than 6 times per day. Avoid excessive bladder filling. The bladder capacity during each catheterization should not exceed 500ml.
3.3 For those who have formed a pseudo-channel, a urethral endoscopy must be performed. Use the pressure of the irrigation fluid to find the normal channel, then insert a guide wire into the bladder. Under the guidance of the guide wire, insert the balloon-tipped urinary catheter with the head removed into the bladder. Keep it for 2-3 weeks. After the pseudo-channel heals, it can be removed. To prevent urethral stenosis, it is necessary to wait until then.
VII. Ingestion into the Vagina
Ingestion into the vagina is a specific complication of catheterization in female patients.
1. Causes of the incident
Female catheterization is usually not difficult, but in elderly women, there may also be cases of catheterization failure or ingestion into the vagina. During the elderly stage, due to the relaxation of the perineal muscles and the atrophy of the vaginal muscles, the urethral opening gets trapped in the anterior wall of the vagina, resulting in an ectopic urethral orifice.
2. Clinical manifestations
After the urinary catheter was inserted, no urine flowed out. However, upon physical examination, the patient's bladder was found to be full and distended.
3. Prevention and Treatment
3.1 If the catheterization fails due to the inability to locate the external urethral orifice, one should carefully search for it. The search method is as follows: thoroughly disinfect the external genitalia, put on gloves, with the index and middle fingers of the left hand touching each other and gently inserting 1.5-2 cm into the vagina, then bend the joint of the finger tip, and then pull the anterior vaginal wall tight and outward, in the outwardly turned mucosa, the urethral orifice can be found. The variant urethral orifice is generally not deep.
3.2 If the catheter mistakenly enters the vagina, it should be replaced and reinserted correctly.
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