My father has dementia and pulled out a Foley catheter. Will this cause sepsis?

Question

Hello doctor,

My 86-year-old father with dementia has an indwelling long-term Foley catheter (approximately five years). He has pulled it out several times, but yesterday completely pulled it out and is in the hospital with sepsis. He is in a memory care unit. Is there anything that can be done to prevent him from doing this again?

Please advise.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

Is it that he was unfit for surgery, a catheter was placed due to urinary retention, or is it placed as he is bedridden and cannot go to the toilet? If it was the first case, it is best to place a simple urethral stent procedure that can be done under local anesthesia or simple sedation. If it’s the second case, he can have a condom catheter that can be easily replaced if he pulls it out.

I hope this answers your question.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

I understand your concern. As you have detailed that his bladder is not working, it will make matters challenging, especially he has dementia, so he cannot empty his bladder by self-catheterization. The options are limited as his bladder cannot contract, then better to do a bladder neck incision to render him incontinent, and the catheter can be removed, then he can wear diapers. And he will require a caregiver to be with him always. It is tough to deal with, but the best way to be without a catheter for the nonfunctional bladder is to incise the sphincter endoscopically. Urine will automatically come out, and no need for a catheter, but he will need a change of the diaper 6 to 8 times daily. This will hopefully also reduce the chances for him to have catheter induced UTI (Urinary tract infection).

Thank you.