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Teachable Moment
Less Is More
June 2016

Complications of Indwelling Urinary Catheter Care and Care TransitionsA Teachable Moment

Author Affiliations
  • 1Tinsley Harrison Internal Medicine Residency Program, The University of Alabama at Birmingham, Birmingham
  • 2The University of Alabama School of Medicine, Birmingham
  • 3Clinical Programs, Birmingham/Atlanta Geriatrics Research, Education, and Clinical Center, Birmingham, Alabama
  • 4Birmingham VA Medical Center, Birmingham, Alabama
  • 5Department of Gerontology, Geriatrics, and Palliative Care, The University of Alabama at Birmingham, Birmingham
JAMA Intern Med. 2016;176(6):737-738. doi:10.1001/jamainternmed.2016.0606

A man in his 70s was a resident at a local long-term care (LTC) facility for 5 months prior to this hospital admission. He had a history of vascular dementia, dependency in activities of daily living, and recurrent urinary tract infections (UTIs) that were likely the direct result of chronic use of indwelling Foley catheters. Initially, he was transferred from his LTC facility to the emergency department by ambulance with fevers, chills, and low blood pressure. His urinalysis was consistent with a UTI. On initial examination, we found an indwelling Foley catheter that had resulted in a 3-cm erythematous ventral penile erosion that was exquisitely tender to touch with a yellow pus-like discharge. Initially, we removed the catheter and started antibiotics for the UTI and his penile wound. Within 24 hours of removing the catheter, he developed urinary retention. He ultimately required a suprapubic catheter to allow secondary wound healing of the penile erosion.

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