Visible haematuria post catheter question

[regerterb]

Hello,

I am a community nurse currently and had a patient today who required an IDC change-have never had any issues in the previous 11 I have put in for him.

Today, removed old catheter, nil issues-inserted fine, he has an enlarged prostate but this has again, never been an issue prior-went in easily, nil resistance, no pain voiced by the client-about 10ml clear urine flowed post insertion (client had emptied bladder 10 minutes prior to visit)-inflated balloon, still-no pain voiced, nil issues. I attached the valve and noticed rose coloured urine had flowed into catheter. He has previously been on Warfarin (anticlot) which has caused some rose return urine before but has cleared up quickly. He is no longer on Warfarin. I advised him to keep any eye on it, drink plenty of water and I would call him to follow up. As I said, I called him at noon-he stated urine flowing fine, clear, nil issues. Then he calls again at 4:30pm-the time we shut and states that he has had no urine flow at all today and catheter completely blocked....I am thinking he may have a UTI as he could not recall that he had called me previously....I advised him to call an ambulance.

Does anyone have any ideas as to what could have happened as the catheter went in so nicely as usual....

[CCU BSN RN]

1. Most recent set of Coags? Did he stop Warfarin but start Xarelto or Elaquis or something instead?

2. probably trauma from insertion since it cleared up within a few hours.

3. UTI is definitely possible especially with chronic foley

4. His cath isn't flowing because it's occluded, likely by clots. Needs some good, old-fashioned hand-irrigation, and if it doesn't stay patent after that, CBI.

How old is he? Diagnoses? Prostate CA? History of radiation to the pelvis/abdomen as treatment for cancer of any kind will make all your tissue friable, easier for this to happen. Why did they stop his coumadin/what was he on it for, and is he on a newer agent instead?

[Scottishtape]

Another thought too is possible inflammation from cath insertion stopping the flow of urine.

With the hematauria going away soon after, I agree it was probably from trauma, which could've caused the inflammation, leading to him not being able to urinate.

You stated he has an enlarged prostate already, even a slight amount of inflammation from trauma could potentiate blockage.