Hydroureteronephrosis due to a misplaced suprapubic catheter

Area of Science:

• Urology
• Pediatric Surgery
• Medical Imaging

Background:

• Suprapubic catheterization is a common procedure for urinary diversion.
• Ureteral catheterization during suprapubic catheter placement is an exceedingly rare complication.
• Pediatric patients with complex pelvic trauma present unique surgical challenges.

Observation:

• A pediatric patient with a history of severe pelvic fracture and urethral distraction defects post-motor vehicle accident underwent suprapubic catheterization.
• The suprapubic catheter was inadvertently placed within the left ureter.
• This malposition resulted in left-sided hydroureteronephrosis.

Findings:

• The case highlights the extreme rarity of unintentional ureteral catheterization during suprapubic catheter insertion.
• Diagnostic imaging was crucial in identifying the misplaced catheter and subsequent renal complications.
• Timely intervention, guided by imaging, was essential in managing the complication.

Implications:

• This case underscores the critical need for meticulous surgical technique and vigilant intraoperative monitoring during suprapubic catheter placement, especially in complex pediatric pelvic trauma.
• Emergent imaging evaluation is paramount for diagnosing and managing rare complications like ureteral misplacement.
• Prompt recognition and intervention can prevent severe sequelae such as hydroureteronephrosis and potential renal damage.