Adverse Events Following Diagnostic Urethral Catheterization in the Pediatric Emergency Department

Area of Science:

• Pediatric Emergency Medicine
• Urology
• Patient Safety

Background:

• Diagnostic urethral catheterization (UC) is a common procedure in pediatric emergency settings.
• Understanding the risks and complications of UC in young children is crucial for informed clinical decision-making.

Purpose of the Study:

• To evaluate the incidence and types of adverse events following diagnostic urethral catheterization (UC) in children aged 3-24 months.
• To assess the impact of these adverse events on patients and their families, including healthcare utilization and parental work/school absence.

Main Methods:

• A prospective cohort study involving 199 children aged 3-24 months who underwent diagnostic UC in a tertiary-care pediatric hospital's emergency department.
• Parents were interviewed via phone 7-10 days post-procedure using a standardized questionnaire to identify complications.
• Primary outcome was any unfavorable event within 7 days, including painful urination, genital pain, urinary retention, hematuria, or secondary UTI.

Main Results:

• Overall, 21% of children experienced at least one adverse event within 7 days of UC.
• The most frequent complications included painful urination (10%), genital pain (8%), and urinary retention (6%).
• Male sex and age between 12-23 months were associated with an increased risk of adverse events. A small percentage of parents required further medical care or missed work.

Conclusions:

• Diagnostic urethral catheterization (UC) is associated with a significant rate of adverse events (21%) in young children within a week.
• The findings suggest that UC should be employed judiciously in pediatric patients, balancing its diagnostic utility against the potential for negative outcomes.
• Further research may explore alternative methods or strategies to mitigate UC-related complications in this age group.