Penile laceration from a Foley catheter

Traction-induced penile laceration has not been reported previously as a complication of long-term indwelling Foley catheterization. Four occurrences of this injury in three elderly, demented patients were observed in an acute-care Geriatric Evaluation Unit. The most severe case, a nearly complete transverse laceration of the glans, reepithelialized but did not reapproximate. In the other cases, a laceration along the median raphe reapproximated. In all cases, local treatment was successful in effecting healing, and none of the patients exhibited signs or symptoms of systemic illness. These injuries were caused by prolonged traction on the unsecured Foley between the inflated balloon and the weighted collection system producing a local ischemic necrosis. This complication can be prevented by securing the Foley to the patient with tape, ensuring that the drainage system is properly supported, and by attention to patient position.