Oliguria after suprapubic catheter change | Figure 1

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Oliguria after suprapubic catheter change

A patient came in to the ED complaining that since his suprapubic catheter was changed his output became significantly less. I assessed the patient at about 1300 and he had 100ml, give or take, of urine in the bag. the bag was last emptied at about 0800. Bladder scan showed that the bladder was empty and the urine dip was positive for nitrites and leukocytes. There was no change in his fluid intake.

The patient claims that output becomes reduced each time the catheter is changed but I neglected to ask how it resolved in the past as he was moved to a different area in the department due to his hypotension and bradycardia which is chronic and was already being investigated for by his physician prior to our encounter. But if reduced UO happens every time it leads me to believe that sympathetic nervous system is stimulated when they change the catheter?

Really curious, thoughts?

Similar cases

59 years old male patient; "when I eat watermelon I see watermelon seeds in my urine." This figure from his cystoscopy. He is right. We see some seeds in the bladder.

have a 40-50 year old male. He went to the whole 30 diet about a month ago. Since changing his diet he has been passing this orange sand like substance randomly. Patient stated it does burn to urinate. Dipped the urine which showed nothing. What is going on? I have never seen this.

Male aged 85 long term catheter draining freely. Urine has two distinct colours which don't mix. Bag had been changed, fluids increased but still draining looking like this.

Interested to see if anyone can give me a spot dx on this? Pt was an elderly male with TBI s/p 8 foot fall off his camper. He was unresponsive to pain and intubated for 2 weeks. When emptied his urine bag I noticed this white colored clusters floating in the urine. I eventually noticed them more and more and scooped a few out to investigate further. Once emptied from the bag, these clusters would float to the top of the urine. They had a very crystallized appearance almost like a sandy/sugary texture. I have seen tiny clumps of fat in blood samples of pts with high cholesterol/lipids before and that is what these reminded me of at first, but the texture of these clusters was very gritty and they were delicate, almost like a chain link, not lumpy like the fat in the blood.