Harpoon device for removal of obstructed balloon catheters

An alternative approach of cystoscopy-guided removal of a recalcitrant foley catheter

Foley balloon malfunction can result in recalcitrant catheters. Management approaches for troubleshooting this rare occurrence have been described in the literature, including the more invasive methods such as the use of cystoscopy for direct visualization. We describe a case of our endourologic management of a retained 14F temperature-probe foley catheter in a fifty-nine-year-old female patient.

Removing nasal packing in epistaxis: what to do in the case of an undeflatable foley catheter balloon

Introduction Undeflatable Foley catheter balloons adapted for use as nasal packing in epistaxis represent a possible complication.

Case Reports We report on three cases in which Foley catheter balloons adapted for use as posterior nasal packing in epistaxis failed to deflate. In one patient, deflation was achieved by simply using the fingertips to massage the segment of the catheter collapsed by the fixation device. In the second case, the Foley balloon was removed by the oral route after sectioning the catheter. In the third patient, the Foley catheter was successfully deflated after sectioning.

Discussion The probable causes of the undeflatable balloons in these cases were a blockage or lumen collapse of the balloon or a malfunction in the valve system. Although no definitive method has been established for dealing with this complication, the options proposed are the following: manipulation to restore the permeability of the segment of the catheter collapsed by the fixation device, if this is the case; sectioning the catheter or inserting a stiletto catheter; bursting the balloon; or removing it by the oral route. The latter option is apparently the most appropriate for the otolaryngologist in cases unrelated to simple collapse caused by the fixation device.

How to manage a urinary catheter balloon that will not deflate

On occasion, difficulty will be encountered removing an indwelling urethral catheter. This may be as a consequence of failure of the catheter balloon to deflate. This article reviews the published data on managing the non-deflating Foley catheter balloon, and suggests an evidence-based sequence of interventions to deflate the catheter balloon.

Review of techniques to remove a Foley catheter when the balloon does not deflate

Failure of a Foley balloon to deflate may be caused by a faulty valve mechanism, blockage of the inflation channel, or, rarely, crystallization of the fluid within the balloon. We discuss the approach to successful management and present a stepwise algorithm to remove the catheter safely and expeditiously.

Management of undeflatable Foley catheter balloons in women

The inability to deflate a self-retaining balloon catheter is a rare problem but may be encountered by physicians. Many techniques have been described to solve the problem, some of which may be dangerous. The technique must not disturb the patient or create any additional morbidity. Those methods commonly used are the instillation of ether, liquid paraffin, chloroform or mineral oil through the inflation channel the use of a fine wire to burst the balloon or to recanalize the obstructed inflation channel; bursting or deflating the balloon through suprapubic, transvaginal or urethral routes: and the overinflation technique. The techniques which might be most appropriate for women are explained in a stepwise manner. First the catheter is cut in the proximal segment of the valve. If this is not successful, a ureteric catheter stylet is advanced through the inflation channel until it touches the balloon. If this is still unsuccessful, the balloon is deflated through the drainage channel using the technique proposed by Davies and Thomas. As a second choice, an intravenous cannula with its inner needle drawn back is advanced through the urethra next to the catheter; towards the balloon which, is then punctured with the inner needle. If these steps are followed, the patient will have no additional discomfort and no trauma to the surrounding tissues, and there will be no need for cystoscopy or any other expensive intervention.