Ann Rehabil Med.  2016 Dec;40(6):1140-1143. 10.5535/arm.2016.40.6.1140.

Ureteral Rupture Caused by a Suprapubic Catheter in a Male Patient With Spinal Cord Injury: A Case Report

• Choi HJ
• Lee CH
• Shin H

• KMID: 2371349
• DOI: http://doi.org/10.5535/arm.2016.40.6.1140

Abstract

Spinal cord injury (SCI) may lead to urinary system disturbances. Patients with SCI usually have neurogenic bladder, and treatment optionss for this condition include clean intermittent catheterization and a permanent indwelling urethral or suprapubic catheter. Complications of catheterization include urinary tract infection, calculi, urinary tract injury, bladder contraction, bladder spasm, renal dysfunction, bladder cancer, and so forth. To the best of our knowledge, ureteral rupture is an unusual complication of catheterization, and ureteral rupture has been rarely reported in SCI patients. Therefore, here we report a case of ureteral rupture caused by a suprapubic catheter used for the treatment of neurogenic bladder with vesicoureteral reflux in a male patient with SCI. Due to SCI with neurogenic bladder, ureteral size can be reduced and the suprapubic catheter tip can easily migrate to the distal ureteral orifice. Thus, careful attention is required when a catheter is inserted into the bladder in patients with SCI.

Keyword

Urinary catheterization; Rupture; Spinal cord injuries

MeSH Terms

Catheterization
Catheters*
Humans
Intermittent Urethral Catheterization
Male*
Rupture*
Spasm
Spinal Cord Injuries*
Spinal Cord*
Ureter*
Urinary Bladder
Urinary Bladder Neoplasms
Urinary Bladder, Neurogenic
Urinary Calculi
Urinary Catheterization
Urinary Tract Infections
Vesico-Ureteral Reflux

Figure

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  Fig. 1 Contrast computed tomography (axial section) showing retroperitoneal free air and a hematoma (arrow).

• 

  Fig. 2 Contrast computed tomography (coronal section) showing retroperitoneal free air and hematoma due to right distal ureteral rupture (arrow).

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  Fig. 3 A radiograph of the kidney, ureter, and bladder showing extravasation of the radiocontrast from the ruptured ureter (arrow).

Reference

1. Sezer N, Akkus S, Ugurlu FG. Chronic complications of spinal cord injury. World J Orthop. 2015; 6:24–33. PMID: 25621208.

2. Hunter KF, Bharmal A, Moore KN. Long-term bladder drainage: suprapubic catheter versus other methods: a scoping review. Neurourol Urodyn. 2013; 32:944–951. PMID: 23192860.

3. Katsumi HK, Kalisvaart JF, Ronningen LD, Hovey RM. Urethral versus suprapubic catheter: choosing the best bladder management for male spinal cord injury patients with indwelling catheters. Spinal Cord. 2010; 48:325–329. PMID: 19823191.

4. Frickmann H, Jungblut S, Hanke P. Ureteral rupture when changing a suprapubic vesical catheter. Urologe A. 2007; 46:278–280. PMID: 17180396.

5. Hale N, Baugh D, Womack G. Mid-ureteral rupture: a rare complication of urethral catheterization. Urology. 2012; 80:e65–e66. PMID: 22999452.

6. Baker KS, Dane B, Edelstein Y, Malhotra A, Gould E. Ureteral rupture from aberrant Foley catheter placement: a case report. J Radiol Case Rep. 2013; 7:33–40.

7. Ishikawa T, Araki M, Hirata T, Watanabe M, Ebara S, Watanabe T, et al. A rare complication: misdirection of an indwelling urethral catheter into the ureter. Acta Med Okayama. 2014; 68:47–51. PMID: 24553489.

8. Anderson BW, Greenlund AC. Ureteral cannulation as a complication of urethral catheterization. Korean J Urol. 2014; 55:768–771. PMID: 25405021.

9. Jeong SJ, Cho SY, Oh SJ. Spinal cord/brain injury and the neurogenic bladder. Urol Clin North Am. 2010; 37:537–546. PMID: 20955905.