Urologist Places Catheter in Patient Causing Voiding Problems

This case involves a forty-six-year-old male who presented to the hospital with an inability to void his bladder. Two weeks prior to his presentation, the patient had been involved in a minor car accident. In the hospital, it was determined that the patient suffered a posterior urethral injury, with possible surgery as treatment. The urologist was called after both nursing and resident physicians had trouble placing a catheter. After several attempts, the urologist was finally able to place a catheter, and the hospital staff continued with his treatment plan. The patient was discharged from the hospital after a few weeks. Several months later, the patient complained of continued problems with voiding urine and an added anxiety whenever attempts were made to void the bladder.

Question(s) For Expert Witness

  • 1. Could catheter placement have added to this patient’s problem with voiding and what are the common complications following reconstructive urethral surgery?

Expert Witness Response E-000182

The main complications of reconstructive surgeries of the posterior urethra include recurrent stricture, infections, hematomas, and psychological and/or erectile disfunction depending on the severity and extent of the initial injury. Recurrent stricture of the urethra is the most common complication, although most cases can be fixed with repeat operations or dilation/incision for a short period of time. When the neck of the bladder is not involved in any posterior urethral injuries, the return of continence in patients seems to be easier to achieve. Anterior urethral injuries share similar complication patterns to those of the posterior urethra.

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