Sun Hye Jeong MD, Presenter: Nothing to Disclose

Seong Jin Park MD, PhD, Abstract Co-Author: Nothing to Disclose

Hae-Kyung Lee MD, Abstract Co-Author: Nothing to Disclose

Beom Ha Yi, Abstract Co-Author: Nothing to Disclose

Jang Gyu Cha MD, Abstract Co-Author: Nothing to Disclose

Hye Lin Kim, Abstract Co-Author: Nothing to Disclose

Sun Jung Rhee MD, Abstract Co-Author: Nothing to Disclose

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

To evaluate the efficacy of urethral catheterization using the hydrophilic Terumo guidewire under fluoroscopic guidance in patients with a traumatized urethra after a failed attempt at blind catheterization.

We performed 543 cases of diagnostic urethrography to evaluate urethral abnormalities. From these, we diagnosed a traumatized urethra in 39 studies of 38 men; urethrography showed leakage of contrast media from the urethra (n=31), urethral disruption (n=16), partial urethral obstruction (n=21), complete urethral obstruction (n=9), and pseudolumen formation (n=3). Patient age ranged from 41 to 85 years (mean age, 63 years). The causes of the urethral injuries were straddle injuries (n=6), motor vehicle accidents (n=3), traumatic self-removal of a catheter (n=12), and iatrogenic urethral injury during catheter placement (n=18). All patients underwent blind urethral catheterization that failed. After urethrography, we tried to insert a hydrophilic Terumo guidewire through the urethra into the urinary bladder, and then to place a three-way balloon retention urethral catheter (Sewoon Medical, Korea) into the bladder guided by the prior passage of guidewire under fluoroscopy. If we had difficulty in inserting the guidewire, we repeated the procedure to locate the proximal urethra through the injured portion. We recorded the time taken for urethral catheterization.

Of the 39 trials, 34 (87.2%) resulted in successful placement of the three-way balloon catheter in the bladder guided by the guidewire. The five men in whom catheterization failed underwent cystostomy (n=4) or urethroscopic-guided urethral catheterization (n=1). The time taken for urethral catheterization ranged from 2 to 52 minutes (mean 25 minutes). No complications occurred.

Hydrophilic guidewire-assisted urethral catheterization in patients with a traumatized urethra is a safe, simple technique for relieving acute bladder retention after a failed attempt at blind catheterization. This technique should be considered before resorting to invasive cystostomy or urethroscopic-guided catheterization in cases of failed blind catheterization.

Placement of urethral catheter into the injured urethra for preserving its patency and subsequent repair of urethral stricture, is easier than urethral reconstruction after suprapubic catheterization.

Jeong, S, Park, S, Lee, H, Yi, B, Cha, J, Kim, H, Rhee, S, et al, 0, The Efficacy of Urethral Catheterization with a Hydrophilic Guidewire in Patients with a Traumatized Urethra for Treating Acute Bladder Retention after a Failed Attempt at Blind Catheterization.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8010512.html