Intravesical Retention of a Fractured Reused Nelaton Catheter in the Postpartum Period: A Case Report

Abstract

Introduction: Urinary catheterization is common in obstetric practice, but catheter fracture with intravesical retention is very rare and may result in infection, irritative urinary symptoms, or calculus formation if not recognized and removed.

Objective: To describe the presentation and management of a fractured reused Nelaton catheter retained in the urinary bladder after delivery.

Case Report: A 35-year-old woman, parity 4, was referred four hours after a vaginal delivery assisted by a traditional birth attendant because of a retained placenta and a fractured urethral catheter. A midwife had inserted a repeatedly reused Nelaton catheter to empty the bladder. During withdrawal, a cracking sound was heard and part of the catheter remained inside the urinary tract. The patient was hemodynamically stable. The placenta was subsequently delivered completely with gentle traction and fundal pressure. Ultrasonography demonstrated a hyperechoic intravesical foreign body consistent with the catheter fragment. Open surgical removal through laparotomy retrieved a 13-cm catheter segment. The patient was discharged on postoperative day 4 with bladder catheterization planned for seven days. At one-month follow-up, she was clinically well and reported no voiding difficulty.

Conclusion: Reuse of a disposable Nelaton catheter may reduce material integrity and contribute to fracture during removal. Catheters should be inspected before and after use, single-use devices should not be reused, and a missing segment should prompt immediate imaging and complete retrieval.