Evaluating the cost of iatrogenic urethral catheterisation injuries

Introduction Technique is vital to prevent urethral trauma during urethral catheterisation (UC). Education programmes are helpful but are not compulsory and safe UC remains operator dependent. Traumatic UC is associated with increased morbidity, length of stay, resource utilisation and surgical inte...

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Bibliographic Details
Published in:Irish journal of medical science 2017-11, Vol.186 (4), p.1051-1055
Main Authors: Bhatt, N. R., Davis, N. F., Addie, D., Flynn, R., McDermott, T. E. D., Manecksha, R. P., Thornhill, J. A.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Family Medicine
Female
General Practice
Humans
Iatrogenic Disease - economics
Internal Medicine
Male
Medicine
Medicine & Public Health
Middle Aged
Original Article
Prospective Studies
Urinary Catheterization - adverse effects
Urinary Catheterization - economics
Urinary Catheterization - methods
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Summary:Introduction Technique is vital to prevent urethral trauma during urethral catheterisation (UC). Education programmes are helpful but are not compulsory and safe UC remains operator dependent. Traumatic UC is associated with increased morbidity, length of stay, resource utilisation and surgical intervention. Aim To determine the cost of iatrogenic urethral injuries managed in a tertiary referral centre over a 6-month period. Methods A 6-month prospective study monitored iatrogenic urethral injuries secondary to traumatic UC. Included were referrals from district hospitals and inpatient consultations relating to urethral injury caused by traumatic UC. The added cost of management was estimated. Results Thirteen iatrogenic urethral injuries were recorded in 6 months. Management included open surgery for a ruptured bladder ( n  = 1), flexible cystourethroscopy ( n  = 10), suprapubic catherisation ( n  = 4), 3-way catheterisation ( n  = 4) and catheter re-insertion under direct vision ( n  = 6). The cost of acute management of these injuries was approximately €50,000 including theatre costs, ambulance transfer, hospital stay, procedural and equipment costs and short-term follow-up care. Conclusion Iatrogenic injuries during UC represent a significant cost burden to the healthcare system. Training programmes should be compulsory for all healthcare professionals routinely involved in catheterisation procedures.
ISSN:0021-1265
1863-4362
DOI:10.1007/s11845-016-1451-5