Study design, materials and methods
Material and methods : A 43 – Year- old man , Victim of blast explosion Injury , had spinal cord injury T10 and below underwent thoracic spinal cord decompression and fusion , Paraplegic, no sensation below umbilicus On indwelling foley catheter , history of DVT on anticoagulant treatment
Admitted electively under urology care for Intravenous antibiotic due to positive urine culture and treatment of right Vesicoureteral junction stone 6mm by cystoscopy+- Cystolithpexy VS laser fragmentation,. During admission patient need foley catheter exchange ended up with Traumatic URETHRAL INJURY with active bleeding complicated by hemorrhagic shock , Treated by Nephromax high pressure balloon catheter dilation
A week later, Patient discharge on anticoagulant , bleeding had completely stopped and become asymptomatic
Interpretation of results
BACKGROUND :
This case highlights a very unusual cause of urethral bleeding and is very rarely encountered,. It is clinical challenges of control urethral bleeding due to indwelling urinary catheter that did not cure with usual methods of urethral bleeding management , This case brings to the forefront a lifestyle choice that has considerable and significant urological morbidity. A significant proportion of people use this practice. It is also a very poorly researched area, with only a handful of relevant literature.
Case Report :
A 43 – Year- old man , Victim of blast explosion Injury , had spinal cord injury T10 and below underwent thoracic spinal cord decompression and fusion , Paraplegic, no sensation below umbilicus On indwelling foley catheter , history of DVT on anticoagulant treatment
Admitted electively under urology care for Intravenous antibiotic due to positive urine culture and treatment of right Vesicoureteral junction stone 6mm by cystoscopy+- Cystolithpexy VersuS laser fragmentation,. During admission patient need foley catheter exchange ended up with Traumatic URETHRAL INJURY with active bleeding complicated by hemarrogic shock , Treated by Nephromax high pressure balloon catheter dilation
A week later, Patient discharge on anticoagulant , bleeding had completely stopped and become asymptomatic
Discussion:
Urethral bleeding is a relatively common reported event. Different etiologies characterized this symptoms in males rather than females . In male patient urethral bleeding might be result from life threatening conditions like traumatic urethral injury either from unusual sexual practice or transurethral insertion of traumatic foreign bodies that requiring hospital admission or other causes that linked to sexual transmitted disease or urethral neoplasms
In general , the most common methods to manage any external bleeding by applying pressure over bleeding site but it might not be effective to manage the internal bleeding . Thus , the main way to control urethral bleeding is to insert a urethral indwelling catheter or in case of incapability of passing a catheter, applying pressure on the perineum and intermittent penile urethral compression are recommended.