Urologist Permanently Damages Patient During Catheter Insertion

Case Overview

This case involves a 64-year-old male patient with a history of urinary incontinence who had his prostate gland surgically removed. He presented to a urologist for a bulking agent injection to help with his incontinence. The day after the procedure, the patient experienced severe abdominal pain and returned to the urologist’s office. He was diagnosed with an obstructed urethra. The urologist attempted to pass a catheter through the patient’s urethra several times to break through the obstruction, but each attempt failed. Because of the significant force used to insert the catheter, the patient suffered severe trauma to his urethra. An expert in urology was sought to review the facts of the case and determine whether or not the attending urologist performed the procedure in question according to the standard of care.

Questions to the Urology expert and their responses

Please describe your background in urology.

I have performed over 500 radical prostatectomies and I am very familiar with the complication of urinary incontinence.

Do you routinely treat patients like the one described above?

I routinely treat patients for prostate cancer with radical prostatectomy. And I take care of any of my patients who have urinary incontinence as a result.

Have you ever had a patient sustain this injury due to improper catheter insertion? What was the result?

Every urologist has experienced (or caused) urethral trauma during catheter insertion. However, trauma leading to irreversible damage, or damage requiring extensive surgery, is and should be very rare. It also calls into question the technique used, and whether catheter insertion should have been stopped and another technique (e.g., cystoscopy, or suprapubic tube insertion) should have been employed.

About the expert

This expert has over a decade of experience in the field of urology. He earned his BS from Harvard University, and his MPH and MD from Columbia University. This expert then completed an internship in general surgery and a residency in urology at Columbia University followed by a fellowship in urologic oncology at the University of Chicago Medical Center. He is a member of numerous prestigious medical societies and is extremely well-published having authored 31 peer-reviewed papers. His proficiency in research has also allowed him to serve as a reviewer for numerous medical journals. He previously served as an attending urologist at Weiss Memorial Hospital in Chicago. Currently, he is an attending urologist at a hospital as well as an assistant professor of urology at an ivy league university, both in New York.