Obstructive uropathy secondary to accidental ureteric placement of indwelling urinary catheter at time of caesarean section

Obstructive uropathy secondary to accidental ureteric placement of indwelling urinary catheter at time of caesarean section | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Obstructive uropathy secondary to accidental ureteric placement of indwelling urinary catheter at time of caesarean section Sara Hariz, Priti Pradhan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4287574/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract This case describes a rare complication of Foley catheter insertion where accidental instrumentation of a ureter occurred at time of caesarean section with subsequent development of bladder obstruction and acute kidney injury. This has only been documented in literature a handful of times however rapid identification and management can minimise associated long term implications. As such this necessitates greater awareness of this possible complication and risk factors such as pregnancy that may predispose patients. “Caesarean” “ureteric instrumentation” “obstructive uropathy” “bladder obstruction” “kidney injury” Introduction Foley catheter insertion is routine practice both at time of caesarean section and in labour for certain indications. We describe a case where a catheter was inserted at time of caesarean section where it was accidentally placed and inflated in the left ureteric orifice, a complication not discovered until the following day. On review of the literature there is a potential of increased risk of misplacement into the ureters in the context of the gravid uterus altering the position of the uretero-vesical orifices and physiologic hydronephrosis associated with pregnancy. We also explore methods of identifying potential aberrant catheter placement to allow for earlier diagnosis which is particularly important in this population who often have altered sensation in the context of epidural or spinal analgesia. Case description A 31-year-old female underwent an uncomplicated lower segment caesarean section (LSCS) at term for DCDA twins where an indwelling catheter (IDC) was placed after administration of spinal anaesthesia for an elective LSCS. The following morning a medical review was requested for urine output of 0.2ml/kg/hr of dark concentrated urine which had not improved overnight despite significant fluid resuscitation. Biochemical analysis showed a significant acute kidney injury with a creatinine of 120. Throughout the proceeding hour she developed significant abdominal pain and CT confirmed IDC tip was protruding 5cm into the left ureter with bilateral hydronephrosis. Retraction of the catheter resulted in decompression of the bladder and resolution of the obstructive uropathy. Subsequent follow-up ultrasound confirmed no evidence of long term complication. Discussion This is a notably rare complication of urinary catheter placement however of the small number of known cases the identified risk factors tend to be female sex and neurogenic bladder ( 1 ). On review of the literature, we have found five other cases documented in pregnant or immediately postpartum patients ( 2 – 6 ). Physiological changes in pelvic anatomy in pregnancy such as hydronephrosis may contribute to the risk of this complication ( 2 , 4 ). Of these cases, majority in pregnancy are involving the right ureter rather than the left. Dilation of the right ureter in pregnancy is a known phenomenon and may explain the higher incidence of accidental instrumentation however interestingly the contralateral side was instrumented in this case ( 7 , 8 ). Furthermore, females are deemed at higher risk due to a shorter urethra ( 9 ). The gravid uterus in the setting of twin pregnancy may have caused protrusion of the ureteric orifices in line with the urethral orifice thus leading to the accidental instrumentation. Proposed methods of identification include recognition of increased length of catheter inside the patient, reduced urine output non-responsive to fluid resuscitation and acute kidney injury ( 2 , 9 ). Our patient also had pain secondary to bladder distension despite a draining catheter. A significant proportion of patients also developed pyelonephritis however of this group none were pregnant or postpartum, presumably due to need for longer term catheterisation in order to predispose them to this complication than typically seen in the post-operative or postpartum population ( 7 ). Whilst this is an exceedingly rare complication practitioners should consider this in addition to other causes in patients who are oliguric post caesarean section and further investigate with thorough examination, biochemical analysis and imaging if indicated. Conclusion This case underscores the importance of vigilance during catheter placement, particularly in the context of caesarean sections due the anatomical shift to pelvic organs caused by a gravid uterus. Although an exceedingly rare complication, obstructive uropathy due to ureteric catheter misplacement demands consideration in the differential diagnosis of postoperative oliguria. A heightened awareness among practitioners can facilitate early identification, prompt intervention, and prevention of potential long-term complications. Abbreviations Indwelling catheter (IDC) Lower Segment Caesarean Section (LSCS) Declarations Ethics: Not Applicable Consent to participate: written consent was attained for publication from the patient concerned. Availability of data and materials: Not Applicable Competing interests: The authors declare they have no competing interests Funding: No funding declared Author contributions: All authors read and approved the manuscript Acknowledgements: Not applicable Author information: Not applicable Footnotes: Not applicable References Ishikawa T, Araki M, Hirata T, Watanabe M, Ebara S, Watanabe T, Nasu Y, Kumon H. A rare complication: misdirection of an indwelling urethral catheter into the ureter. Acta Med Okayama. 2014;68(1):47–51. 10.18926/AMO/52144 . PMID: 24553489. Singh R, Singh A, Pratts R, Jain A, Singh M. A Rare Cause of Apparent Anuria After Caesarean Section: A Case Report. Cureus. 2021;13(4):e14400. 10.7759/cureus.14400 . PMID: 33981513; PMCID: PMC8108723. Smekal M, Arumuham V, Tasleem A, Mikhail M, Allen C, Choong S. Retained Urethral Catheter in the Ureter Following Misplaced Insertion in a Postpartum Female. J Endourol Case Rep. 2020;6(2):70–2. 10.1089/cren.2019.0074 . PMID: 32775681; PMCID: PMC7383440. McGregor TB, Sharda R. Retained Urethral Catheter Secondary to Placement in Proximal Ureter. Case Rep Urol. 2016;2016:9178645. 10.1155/2016/9178645 . Epub 2016 Apr 10. PMID: 27144050; PMCID: PMC4842048. Yune JJ, Lightfoot M, Baldwin DD, Hardesty J, Siddighi S. Unsuccessful foley catheterization had an unexpected explanation. Female Pelvic Med Reconstr Surg. 2015 Mar-Apr;21(2):e14-6. 10.1097/SPV.0000000000000111 . PMID: 25185614. Danaie M, Nezameslami A, Mishan M, Mehdikhani B, Mansouri Z. Misplaced Urinary Catheter in the Ectopic Ureter in a Female With Previously Undiagnosed Duplex Ureter: A Rare Case. Cureus. 2022;14(11):e31139. 10.7759/cureus.31139 . PMID: 36479397; PMCID: PMC9723261. Luo R, Lee SL, Ng FC, Koh LT. Inadvertent placement of a urinary catheter into the ureter: A report of 3 cases and review of the literature. Asian J Urol. 2017;4(4):256–61. 10.1016/j.ajur.2016.08.011 . Epub 2016 Sep 4. PMID: 29387559; PMCID: PMC5773021. Brown MA. Urinary tract dilatation in pregnancy. Am J Obstet Gynecol. 1991;164(2):642-3. 10.1016/s0002-9378(11)80039-6 . PMID: 1992717. Sayedin H, Jamieson P. Ureteric trauma caused by urethral catheter insertion: case report and literature review. J Surg Case Rep. 2022;2022(12):rjac563. 10.1093/jscr/rjac563 . PMID: 36540301; PMCID: PMC9759165. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4287574","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":307687189,"identity":"b8e46d14-c31e-4007-b902-8c6595dec807","order_by":0,"name":"Sara Hariz","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5UlEQVRIie3OPWvCUBTG8edy4bhczJqimK9wICC6+FkMQhw7uAitL9N1acnsx3CRjoGALnHPKkKmDgZBHDpUXcTlarZC729+/pwDWNZfJaYAQcalE+qWTADFz6292Wa7F1+d16qTHvYnjBocy9w1JZz2fVekvbbGZvnygbXPMTXNCUK4Qksm8bmEwiqYT2FOvCiXJ6EnTFLtip9rUjkaE2Qhna8kTKRQU3gPIqgHj2U5tQK9ZlLUrNU59h2pBi3zY6HMCv3GXpTsiu/huEGV2SIzPnbRvR1NAPlwf29ccm9ZlvUf/ALtWT3aCQXF1QAAAABJRU5ErkJggg==","orcid":"","institution":"Women's and Children's Hospital","correspondingAuthor":true,"prefix":"","firstName":"Sara","middleName":"","lastName":"Hariz","suffix":""},{"id":307687190,"identity":"1c9d2802-d2a8-48a9-91c9-46a0aabfc6fd","order_by":1,"name":"Priti Pradhan","email":"","orcid":"","institution":"Women's and Children's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Priti","middleName":"","lastName":"Pradhan","suffix":""}],"badges":[],"createdAt":"2024-04-18 11:57:06","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4287574/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4287574/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":57939570,"identity":"c789b125-cee1-4b81-91a9-6ee1f6dd3e4d","added_by":"auto","created_at":"2024-06-07 18:23:36","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":163836,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4287574/v1/2b15aee3-e848-431b-8576-705b908ce000.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Obstructive uropathy secondary to accidental ureteric placement of indwelling urinary catheter at time of caesarean section","fulltext":[{"header":"Introduction","content":"\u003cp\u003eFoley catheter insertion is routine practice both at time of caesarean section and in labour for certain indications. We describe a case where a catheter was inserted at time of caesarean section where it was accidentally placed and inflated in the left ureteric orifice, a complication not discovered until the following day. On review of the literature there is a potential of increased risk of misplacement into the ureters in the context of the gravid uterus altering the position of the uretero-vesical orifices and physiologic hydronephrosis associated with pregnancy. We also explore methods of identifying potential aberrant catheter placement to allow for earlier diagnosis which is particularly important in this population who often have altered sensation in the context of epidural or spinal analgesia.\u003c/p\u003e "},{"header":"Case description","content":"\u003cp\u003eA 31-year-old female underwent an uncomplicated lower segment caesarean section (LSCS) at term for DCDA twins where an indwelling catheter (IDC) was placed after administration of spinal anaesthesia for an elective LSCS. The following morning a medical review was requested for urine output of 0.2ml/kg/hr of dark concentrated urine which had not improved overnight despite significant fluid resuscitation. Biochemical analysis showed a significant acute kidney injury with a creatinine of 120. Throughout the proceeding hour she developed significant abdominal pain and CT confirmed IDC tip was protruding 5cm into the left ureter with bilateral hydronephrosis. Retraction of the catheter resulted in decompression of the bladder and resolution of the obstructive uropathy. Subsequent follow-up ultrasound confirmed no evidence of long term complication.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis is a notably rare complication of urinary catheter placement however of the small number of known cases the identified risk factors tend to be female sex and neurogenic bladder (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOn review of the literature, we have found five other cases documented in pregnant or immediately postpartum patients (\u003cspan additionalcitationids=\"CR3 CR4 CR5\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Physiological changes in pelvic anatomy in pregnancy such as hydronephrosis may contribute to the risk of this complication (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Of these cases, majority in pregnancy are involving the right ureter rather than the left. Dilation of the right ureter in pregnancy is a known phenomenon and may explain the higher incidence of accidental instrumentation however interestingly the contralateral side was instrumented in this case (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Furthermore, females are deemed at higher risk due to a shorter urethra (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). The gravid uterus in the setting of twin pregnancy may have caused protrusion of the ureteric orifices in line with the urethral orifice thus leading to the accidental instrumentation. Proposed methods of identification include recognition of increased length of catheter inside the patient, reduced urine output non-responsive to fluid resuscitation and acute kidney injury (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Our patient also had pain secondary to bladder distension despite a draining catheter. A significant proportion of patients also developed pyelonephritis however of this group none were pregnant or postpartum, presumably due to need for longer term catheterisation in order to predispose them to this complication than typically seen in the post-operative or postpartum population (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWhilst this is an exceedingly rare complication practitioners should consider this in addition to other causes in patients who are oliguric post caesarean section and further investigate with thorough examination, biochemical analysis and imaging if indicated.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis case underscores the importance of vigilance during catheter placement, particularly in the context of caesarean sections due the anatomical shift to pelvic organs caused by a gravid uterus. Although an exceedingly rare complication, obstructive uropathy due to ureteric catheter misplacement demands consideration in the differential diagnosis of postoperative oliguria. A heightened awareness among practitioners can facilitate early identification, prompt intervention, and prevention of potential long-term complications.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eIndwelling catheter (IDC)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eLower Segment Caesarean Section (LSCS)\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics: Not Applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConsent to participate: written consent was attained for publication from the patient concerned.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials: Not Applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCompeting interests: The authors declare they have no competing interests\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFunding: No funding declared\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAuthor contributions:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll authors read and approved the manuscript\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAcknowledgements:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNot applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAuthor information:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNot applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFootnotes:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNot applicable\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eIshikawa T, Araki M, Hirata T, Watanabe M, Ebara S, Watanabe T, Nasu Y, Kumon H. A rare complication: misdirection of an indwelling urethral catheter into the ureter. Acta Med Okayama. 2014;68(1):47\u0026ndash;51. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.18926/AMO/52144\u003c/span\u003e\u003cspan address=\"10.18926/AMO/52144\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 24553489.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSingh R, Singh A, Pratts R, Jain A, Singh M. A Rare Cause of Apparent Anuria After Caesarean Section: A Case Report. Cureus. 2021;13(4):e14400. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.7759/cureus.14400\u003c/span\u003e\u003cspan address=\"10.7759/cureus.14400\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 33981513; PMCID: PMC8108723.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSmekal M, Arumuham V, Tasleem A, Mikhail M, Allen C, Choong S. Retained Urethral Catheter in the Ureter Following Misplaced Insertion in a Postpartum Female. J Endourol Case Rep. 2020;6(2):70\u0026ndash;2. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1089/cren.2019.0074\u003c/span\u003e\u003cspan address=\"10.1089/cren.2019.0074\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 32775681; PMCID: PMC7383440.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMcGregor TB, Sharda R. Retained Urethral Catheter Secondary to Placement in Proximal Ureter. Case Rep Urol. 2016;2016:9178645. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1155/2016/9178645\u003c/span\u003e\u003cspan address=\"10.1155/2016/9178645\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2016 Apr 10. PMID: 27144050; PMCID: PMC4842048.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYune JJ, Lightfoot M, Baldwin DD, Hardesty J, Siddighi S. Unsuccessful foley catheterization had an unexpected explanation. Female Pelvic Med Reconstr Surg. 2015 Mar-Apr;21(2):e14-6. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1097/SPV.0000000000000111\u003c/span\u003e\u003cspan address=\"10.1097/SPV.0000000000000111\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 25185614.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDanaie M, Nezameslami A, Mishan M, Mehdikhani B, Mansouri Z. Misplaced Urinary Catheter in the Ectopic Ureter in a Female With Previously Undiagnosed Duplex Ureter: A Rare Case. Cureus. 2022;14(11):e31139. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.7759/cureus.31139\u003c/span\u003e\u003cspan address=\"10.7759/cureus.31139\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 36479397; PMCID: PMC9723261.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLuo R, Lee SL, Ng FC, Koh LT. Inadvertent placement of a urinary catheter into the ureter: A report of 3 cases and review of the literature. Asian J Urol. 2017;4(4):256\u0026ndash;61. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.ajur.2016.08.011\u003c/span\u003e\u003cspan address=\"10.1016/j.ajur.2016.08.011\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2016 Sep 4. PMID: 29387559; PMCID: PMC5773021.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrown MA. Urinary tract dilatation in pregnancy. Am J Obstet Gynecol. 1991;164(2):642-3. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/s0002-9378(11)80039-6\u003c/span\u003e\u003cspan address=\"10.1016/s0002-9378(11)80039-6\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 1992717.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSayedin H, Jamieson P. Ureteric trauma caused by urethral catheter insertion: case report and literature review. J Surg Case Rep. 2022;2022(12):rjac563. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1093/jscr/rjac563\u003c/span\u003e\u003cspan address=\"10.1093/jscr/rjac563\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 36540301; PMCID: PMC9759165.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"“Caesarean” “ureteric instrumentation” “obstructive uropathy” “bladder obstruction” “kidney injury”","lastPublishedDoi":"10.21203/rs.3.rs-4287574/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4287574/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis case describes a rare complication of Foley catheter insertion where accidental instrumentation of a ureter occurred at time of caesarean section with subsequent development of bladder obstruction and acute kidney injury. This has only been documented in literature a handful of times however rapid identification and management can minimise associated long term implications. As such this necessitates greater awareness of this possible complication and risk factors such as pregnancy that may predispose patients.\u003c/p\u003e","manuscriptTitle":"Obstructive uropathy secondary to accidental ureteric placement of indwelling urinary catheter at time of caesarean section","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-05-31 11:50:45","doi":"10.21203/rs.3.rs-4287574/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"548668c6-3287-4596-b25d-ce711910e0ed","owner":[],"postedDate":"May 31st, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-06-07T18:23:30+00:00","versionOfRecord":[],"versionCreatedAt":"2024-05-31 11:50:45","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4287574","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4287574","identity":"rs-4287574","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}