Troubleshooting Foley Catheter Problems Using Point-of-Care Ultrasound

Foley catheter problems are a common reason for patients to present to the Emergency Department (ED). While replacement of the Foley catheter is a common approach, a more nuanced approach can be taken using point-of-care ultrasound (POCUS) to avoid unnecessary exchanges and guide focused interventions.

This article summarizes potential diagnoses and solutions to Foley catheter problems in the ED, aided by use of POCUS.

POCUS can visualize and diagnose causes of decreased or absent urine drainage, hematuria, and balloon malfunction, offering an advantage over commercial bladder scanners. Decreased or absent Foley catheter drainage can be visualized directly or indirectly by seeing a Foley catheter within a distended bladder, and can often be managed using a saline flush or catheter manipulation. POCUS can be used to assess for blood clots within the bladder to determine if the patient would benefit from continuous irrigation and three-way Foley catheter placement. Finally, POCUS can assist with identifying nonfunctioning Foley balloons.

Using POCUS to identify causes of decreased or absent urine drainage, hematuria, and Foley balloon malfunctions can help narrow the differential diagnosis of Foley catheter problems.