Case report by RN Mohapatra: urine leakage in persons with spinal cord injury and using long-term Foley catheters: a simple solution

It is salutary that Mohapatra should draw attention to the leakage of urine around the Foley catheter in spinal cord injury patients. He states:

‘This case report highlights a common, but not often considered, cause of chronic leakage, and a simple effective solution. The persistence of small volumes of residual urine around the Foley catheter should be recognised as a possible source of persistent urine leakage around the catheter’.

This source of error was first described by Cook in 1960.¹ Cook showed that, in the recumbent position, urine pools at the back of the bladder and, despite washing through an indwelling Foley catheter, all the urine is not obtained. Once the patient is sat up, however, further urine can be drained.

These findings were confirmed by Doggart et al.² in 1966, who carried out similar studies on 20 paraplegic patients and found that when patients stood up, after a conventional urine check, as much as 16 ml of urine could be obtained.

These findings are well documented by Tribe and Silver³ and Guttmann.⁴