Life‐threatening urethral hemorrhage after placement of a Foley catheter in a patient with uroseptic disseminated intravascular coagulation due to chronic urinary retention induced by untreated benign prostatic hyperplasia

Abstract

Case A 77‐year‐old man with severe septic disseminated intravascular coagulation following urinary infection was transported to our hospital. He had developed urinary retention induced by untreated prostatic hyperplasia. Immediate drainage with a Foley catheter was successfully carried out, but the hematuria progressed to life‐threatening hemorrhage. Outcome Complete hemostasis was impossible by surgical treatment because the tissue around the prostatic urethra was very fragile and hemorrhagic. Organized treatments (continuous hemodiafiltration combined with polymyxin‐B immobilized fiber column hemoperfusion and systemic treatment with antibiotics and coagulation factors) were commenced soon after the operation. The patient eventually recovered from the septic disseminated intravascular coagulation. Conclusion This case report illustrates the risk of placement of Foley catheters in patients with severe septic disseminated intravascular coagulation.

Keywords

• Benign prostatic hyperplasia
• chronic urinary retention
• PMX
• septic DIC
• urethral hemorrhage