Spontaneous intraurethral catheter knot requiring perineal urethrotomy in a neonate: A case report with review of management and prevention

Infant feeding tubes are routinely used as urethral catheters in neonates and children. Although considered safe, it can lead to significant morbidity if the catheter knots in the bladder. We report a case of a spontaneous urinary catheter knotting in a neonate. It required a perineal urethrotomy for successful removal. A lateral oblique radiograph to characterize the complexity of knot helps in its management. Training of staff involved in the insertion, maintenance or removal of the catheters is essential to decrease catheter related complications.


[1]Arena B, McGillivray D, Dougherty G. Urethral catheter knotting: Be aware and minimize the risk. CJEM. 2002;4(2):108- 10.

[2]Gonzálvez Piñera J, Fernández Córdoba M, Vidal Company A. Nudo intravesical en sonda de tipo Foley: una complicación rara de la cistouretrografía en niños [Intravesical knot of Foley catheter: unusual complication of cystourethrography in children]. An Esp Pediatr. 2000;53(6):601- 603.

[3]Al-Orifi F, McGillivray D, Tange S, et al. Urine culture from bag specimens in young children: are the risks too high? J Pediatr. 2000;137(2):221-26.

[4]Carlson D, Mowery BD. Standards to prevent complications of urinary catheterization in children: should and should-knots. J Soc Pediatr Nurs. 1997;2(1):37-41.

[5]Harris VJ, Ramilo J. Guide wire manipulation of knot in a catheter used for cystourethrography. J Urol. 1976;116(4):529.

[6]Smith AB, Adams LL. Insertion of indwelling urethral catheters in infants and children: a survey of current nursing practice. Pediatr Nurs. 1998;24(3):229-34.

[7]Raveenthiran V. Spontaneous knotting of urinary catheters: clinical and experimental observations. Urol Int. 2006;77(4):317-21.

[8]Lodha A, Ly L, Brindle M, et al. Intraurethral knot in a very-low-birthweight infant: radiological recognition, surgical management and prevention. Pediatr Radiol. 2005;35(7):713- 16.

[9]Mayer E, Ankem MK, Hartanto VH, et al. Management of urethral catheter knot in a neonate. Can J Urol. 2002;9(5):1649-50.

[10]Salama H, AlJuFairi M, Rejjal A, et al. Urinary bladder perforation in a very low birth weight infant. A case report. J Perinat Med. 2002;30(2):188-91.

[11]Romero Pérez P, Lapuerta Torres FE, Amat Cecilia M, et al. Suprapubic cystostomy catheter knotting. Presentation of the first national case and review of the literature. Arch Esp Urol. 2013;66(2):221- 30.

[12]Basavaraju M, Zachariah N, Radhakrishnan R. Intravesical knotting of feeding tube used as urinary catheter in an infant. Pediatr Urol Case Rep. 2016;3(5):199-201.

Kaynak Göster