[Tenckhoff catheter placed in bladder. Case and review]

Area of Science:

• Nephrology
• Urology
• Surgical Complications

Background:

• Stage 5 kidney disease necessitates renal replacement therapy, commonly hemodialysis or peritoneal dialysis.
• Peritoneal dialysis involves a surgically placed catheter, with potential mechanical complications including obstruction, leakage, hernias, malposition, or organ injury.
• Accidental placement of the peritoneal dialysis catheter into the urinary bladder is a rare but serious complication.

Observation:

• A 64-year-old female patient experienced Tenckhoff catheter dysfunction.
• During dialysis solution infusion, the patient reported an urgent need to urinate.
• Abdominal tomography confirmed the Tenckhoff catheter was misplaced within the urinary bladder.

Findings:

• Bladder perforation risk increases with incomplete bladder emptying, prior surgical history, and lower urinary tract abnormalities.
• Risk factors for bladder injury during catheter placement include diabetes, neurogenic bladder, urinary obstruction, and previous abdominal surgeries.
• A case presentation highlights the diagnostic process and confirmation of intravesical catheter placement.

Implications:

• Careful surgical technique is crucial during peritoneal dialysis catheter placement, especially in patients with identified risk factors.
• Pre-operative assessment should consider bladder status, and bladder catheterization may be warranted to ensure complete emptying.
• Prompt diagnosis and management are essential to prevent severe complications associated with intravesical catheter placement.