[heather2084]

I work in the OR, and was trying to catheterize a male pt today. pulling back the covers and holding the penis there was a LOT of excess foreskin hanging at the end. I began pulling it back only to realize that the meatus was minuscule. It appeared barely bigger than the head of a pin. With the help of a CRNA, we attempted to cath him, but there was no way. I have never seen such a site!

Then later as we were doing another case, the floor paged the same dr asking what he wanted to do since they as well were unable to insert a foley. I'm wondering if anyone else has come upon this situation and/or if anyone knows if it's a condition or result of some procedure.

[earle58]

when you opened the meatus, do you think a pedi cath would have fit?

leslie

[heather2084]

i havent seen many pedi caths, but i highly doubt anything was going to fit. it appeared as if there was no opening

[earle58]

hmmmm....wonder if there's a stricture, or even adhesions, in the canal.
sounds like a need for a stat urology consult.
never had this happen.

leslie

[Emmanuel Goldstein]

Originally Posted by heather2084

i havent seen many pedi caths, but i highly doubt anything was going to fit. it appeared as if there was no opening

I saw something like this in a patient from a nursing home. It was explained to me that it was stenosis due to chronic catheterization.

He had a fistula of sorts far down on the underside of the penis where the urine would come out; the actual meatus on the glans was barely there, like you describe.

[skuterkomputer rn]

You cant cath them all. Sometimes you need a urology consult. Experience will tell you when you can and cant cath someone. Even then one of your coworkers may be able to finesse one in. Honestly, the fact that you are still thinking about it means that you probably gave it all you had. Better than trying to force it past a stricture/ prostate/ or whatever it was that you couldnt pass.

[llg]

I've cathed premature babies ... usuing a very small feeding tube. By all means, get the urology consult, but in an emergency ....

[biker nurse]

Afriend of my husband's had to get the opening to his penis made bigger it would take him 3x as long to pee. he was just born that way

[GoLytely]

I have seen these little quick cath kits where the catheter was literally about the diameter of an ice pick.

[earle58]

Originally Posted by motorcycle mama

I have seen these little quick cath kits where the catheter was literally about the diameter of an ice pick.

ouch....as i carefully cross my legs.

leslie