An unusual pelvic foreign body.

CASE PRESENTATION

A 76‐year‐old male veteran with a history of benign prostatic hyperplasia requiring intermittent straight catheterization presented to the emergency department with complaints of a straight catheter in his bladder after he accidentally overinserted it. The patient was seen at an outside emergency department the previous evening where the catheter was reportedly initially visible within the urethra but was pushed further into his bladder during an attempt to remove it. Computed tomography imaging demonstrated a vermicular, radiopaque object within the bladder (Figure 1). A Foley catheter was placed to prevent obstruction, the patient was discharged to follow‐up with urology, and ciprofloxacin was prescribed (Figures 2 and 3).

FIGURE 1

An axial view showing coiled straight catheter (red arrow) and simultaneous Foley catheter balloon (yellow arrow)

FIGURE 2

A sagittal view demonstrating both straight catheter (red arrows) and Foley catheter (yellow arrows) in place with the straight catheter end barely past the pubic symphysis

FIGURE 3

Coronal view of the bladder and penis showing straight (red arrows) and Foley catheters (yellow arrows) in place

On presentation to our hospital, the patient had no other complaints and had appropriate drainage from his Foley catheter without discomfort. The catheter could not be visualized but was palpated at the base of the penis, so urology was consulted for assistance with removal. Once the Foley catheter was removed and the cystoscope was inserted, the straight catheter was found with the tip near the pubic symphysis, and it was removed. The patient was re‐educated on proper catheter technique and had no further complications.

DIAGNOSIS

Overinserted straight catheter

A diagnosis of overinserted straight catheter was made.

Overinsertion of a straight catheter is a rare complication and can be avoided with proper technique. There is no clear research regarding indications for antibiotics in these cases, and urgent removal should be a priority. There is one other case report of a straight catheter retained for 20 years that required surgical removal, demonstrating the need to recognize and act on these findings.