Unusual complications of intermittent self-catheterisation in spinal cord injury patients

Three unusual complications of intermittent self-catheterisation in spinal cord injury patients observed over a period of 30 months are described. (1) Two patients performing intermittent catheterisation with a PVC catheter requiring the use of lignocaine gel to numb the urethra, developed allergic reaction in the form of swelling and erythematous lesions around the external urethral meatus. This rare complication was overcome by switching over to the use of a Lofric catheter instead of a PVC catheter for intermittent catheterisation. (2) Urethral bleeding was observed on three occasions in male paraplegic patients performing intermittent self-catheterisation who had allowed the bladder to become over-distended. Bladder emptying therefore, took nearly 10 min, by which time the Lofric catheter became too sticky in the urethra and required undue force for withdrawal, resulting in trauma to the adherent urethral mucosa and urethral bleeding. By adopting the policy of catheterisation at regular intervals and not allowing the bladder to become distended beyond 450 ml of urine, this complication was never seen again either in these three patients or in any other patient using Lofric catheter for intermittent urethral catheterisation. (3) Failure to drain urine after urethral catheterisation resulting in a panic reaction was observed in a 45 year old woman practising intermittent catheterisation. This unique complication happened because there were no eye holes on the Nelaton catheter.