Male foley came out after irrigation?

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I'm in a new patients home (private duty LPN)... He has a Foley catheter in... The order is to flush it every 2 hours with 60 cc... I had just started my shift and it was time to irrigate. I did. However, the patient yelled in extreme pain. I had no idea what was going on because I was irritating it correctly. I didn't even finish putting all 60 cc in because he was in extreme pain. I come back a few mins later and the catheter had completely come out!

Why would this have happened? What could have caused the extreme pain and then for it to come out?

I had to put a new Foley in.

I'm scared to irrigate it for fear of this happening.

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Was the balloon inflated when you visualized the catheter after "it came out"?

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No it was deflated. I found the the Cath laying near his member with it deflated.

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Specializes in Trauma, Orthopedics.

Did you accidentally irrigate the balloon, resulting in it popping?

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Specializes in SICU.
Did you accidentally irrigate the balloon, resulting in it popping?

This is probably what happened AEB the extreme pain when flushing....

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Specializes in Critical Care.

From your description it's quite possible you were flushing the retention balloon, which likely caused it to fail, leaving nothing to hold the foley in the bladder.

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That would make sense, but no I didn't flush the balloon port.

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Specializes in Med-Surg.

Are you sure that you didn't flush the ballon port? Otherwise I don't know how the balloon got deflated and the foley came out. It also explains the pain.

Unless the foley was in the wrong place to start. Which seems doubtful because it's getting flushed q2hr. Has the patient complained of pain before with flushing?

I am curious why you are having to flush every 2 hours in the home setting. That's pretty frequent and increases the risk of a CAUTI. Could the patient benefit from CBI?

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Did you check the balloon patency after the catheter fell out? Was the balloon still intact, could it be reinflated? or was the balloon broken? If the balloon was broken, the patient's urologist may want to do a cystoscopy to see if a piece of the balloon remained in the bladder. At any rate, the patient's urologist should be notified about the patient's pain when the irrigation was attempted.

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Specializes in Acute Care Pediatrics.

It sounds like the balloon popped. Yowch.

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I agree with karou, an order to irrigate an indwelling catheter q 2hours, does not sound right, I would clarify the order, I can see an order for q 2 days but not q 2 hours. What is the reason for the indwelling catheter and the irrigations?

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Home care is like no other field ...

I had male patients at home who needed irrigation because of ongoing bleeding / blood clots. However, in some cases the foley clogged because of blood clots /sediment. When I irrigate the catheter and it does not irrigate easily or causes pain I stop and have a closer look. I usually check the balloon.

Sometimes strange things happen - one time a patient also voiced pain - the relative had called. I could hear the patient moan and call out on the phone. In any way, when I got to the house the catheter was out (with the balloon partially inflated). Of course I was puzzled at first. Came to find out that when they tried to ambulate the patient they "forgot" the foley and it somehow got caught resulting in pain. That was despite the proper usage of anchoring device on patient's leg.

Just make sure you let the RN and MD know what happened....

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