Is It Safe to Place Catheters in Patients with Suspected Urethral Trauma?

Many texts advise against attempting to pass urinary catheters in blunt trauma patients at clinical risk for urethral injury, as doing so could worsen existing pathology. However, no high-grade evidence exists to support or refute this dogma. These authors conducted a retrospective chart review of a single-center cohort of 46 patients with bladder lacerations, urethral lacerations, or both to assess whether blind catheter insertion worsens injury.

Blind catheter insertion (before injury was discovered) was attempted in six patients with urethral injury and was successful in three. In one patient with urethral injury, a retrograde urethrogram demonstrated a partial tear before the attempt, which was successful. The authors did not find any ev…