The rigid ureteroscope-guided Seldinger technique: a novel and effective method of Foley catheter deployment in patients with challenging transurethral access.
Cole Nelson, Priscilla Anderton, Marawan M El Tayeb et al.
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Case in brief
A patient with acute urinary retention and gross prostatomegaly had exceptionally difficult transurethral access. Foley catheterization remained unsuccessful even after cystoscopic visualization and guidewire access, illustrating that these measures do not always permit catheter passage. The clinicians used a Seldinger-like technique to advance a Foley catheter over a semirigid ureteroscope, securing bladder access while avoiding suprapubic catheterization.
What made this case unusual
Despite cystoscopic visualization and established guidewire access, the Foley catheter could not be deployed; a semirigid ureteroscope served as the conduit for catheter placement.
Diagnostic / clinical pearl
When gross prostatomegaly prevents Foley passage over a guidewire, rigid ureteroscope-guided deployment may provide a salvage route to bladder access.