An Unusual Cause of Retained Suprapubic Foley Catheter-Case Report and Literature Review

Introduction: Suprapubic Foley catheters may be retained as a result of stone formation over the tip of the catheter. However this is not unusual. What is unusual, is for the stone to be firmly adherent to the bladder mucosa making disimpaction very difficult. This is perhaps the first of such case that will be reported in the literature.

Case Report: The patient, Mr. AB, a 56 year old male butcher of the Igbo tribe of south east Nigeria diagnosed of benign prostatic hyperplasia had been on suprapubic catheter for 20 months unchanged! He presented with suprapubic catheter retention and pericatheter leakage of offensive urine. The patient claimed he was neither informed of the need for periodic change of the catheter nor of the need for definitive management of the underlying condition.

He was managed successfully by suprapubic cystostomy, which revealed not only that a stone had formed over the tip of the catheter but that the stone was firmly adherent to the bladder mucosa.

Conclusion: We advocate proper counseling of patients on indwelling catheters and timely replacement of suprapubic catheters to avoid catheter retention. Clinicians should have a high index of suspicion for stone retention and possibly adherence, especially when suprapubic catheters have been indwelling for several months.

Keywords: Retained suprapubic catheter; vesical stone; stone adherence; suprapubic cystostomy.