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Adverse Events Following Diagnostic Urethral Catheterization in the Pediatric Emergency Department

  • Julie Ouellet-Pelletier (a1) (a2), Chantal Guimont (a1), Marie Gauthier (a2) and Jocelyn Gravel (a2)

Abstract

Objectives

The purpose of this study was to assess adverse events associated with diagnostic urethral catheterization (UC) in young children and to determine their impact on the patient and their family.

Methods

This was a prospective cohort study conducted in the emergency department of a tertiary-care pediatric hospital. All 3- to 24-month-old children with fever who had a diagnostic UC were eligible. Parents who consented to participate were contacted by phone within 7 to 10 days after the UC to answer a standardized questionnaire inquiring about complications. The primary outcome was the occurrence of an unfavourable event in the seven days following UC, defined as painful urination, genital pain, urinary retention, hematuria or secondary urinary tract infection. Secondary outcomes included the need for further medical care and the need for parents to miss school or work.

Results

Of the 199 patients who completed the study, 41 (21%) reported a complication: painful urination in 19 (10%) children, genital pain in 16 (8%), urinary retention in 11 (6%), gross hematuria in 9 (5%), and secondary urinary tract infection in 1 (0.5%). Three (1%) parents reported the need for further medical care and three (1%) missed work. Two independent variables (male sex and age 12-23 months) were associated with a higher risk of adverse events.

Conclusions

Urethral catheterization is associated with adverse events in 21% of young children in the week following the procedure. Accordingly, this procedure should be used judiciously in children, considering its potential to cause unfavourable events.

Objectifs

L’étude visait à évaluer les événements indésirables associés au sondage urétral (SU) de diagnostic chez de jeunes enfants, et à déterminer leur incidence sur les patients et leur famille.

Méthode

Il s’agit d’une étude de cohorte, prospective, menée au service des urgences d’un hôpital pédiatrique de soins tertiaires. Étaient admissibles à l’étude tous les enfants âgés de 3 à 24 mois, fiévreux, qui avaient subi un SU de diagnostic. On a téléphoné aux parents qui avaient accepté de participer à l’étude, au cours des 7 à 10 jours suivant le SU pour répondre à un questionnaire commun sur les complications. Le principal critère d’évaluation consistait en l’apparition d’événements indésirables au cours des 7 jours suivant le SU tels que des mictions douloureuses, des douleurs génitales, la rétention urinaire, l’hématurie ou une infection urinaire secondaire. Les critères d’évaluation secondaires comprenaient la nécessité d’autres soins médicaux et la nécessité pour les parents de s’absenter de l’école ou du travail.

Résultats

Sur les 199 parents qui ont participé à l’étude jusqu’à la fin, 41 (21 %) ont fait état de complications : mictions douloureuses chez 19 (10 %) enfants; douleurs génitales chez 16 (8 %) enfants; rétention urinaire chez 11 (6 %) enfants; hématurie macroscopique chez 9 (5 %) enfants et infection urinaire secondaire chez 1 (0,5 %) enfant. Trois parents (1 %) ont indiqué que leur enfant avait besoin d’autres soins médicaux et trois (1 %) se sont absentés du travail. Deux variables indépendantes (sexe masculin et âge de 12 à 23 mois) ont été associées à un risque accru d’événements indésirables.

Conclusions

Le sondage urétral est associé à des événements indésirables chez 21 % des jeunes enfants au cours de la semaine suivant l’intervention. Aussi faudrait-il envisager ce type d’examen de manière judicieuse chez les enfants, compte tenu de l’apparition possible d’événements indésirables.

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Copyright

Corresponding author

Correspondence to: Julie Ouellet-Pelletier, Department of Emergency Medicine, CHU de Quebec (CHUL), 2705, boulevard Laurier, Quebec, QC, G1V 4G2; Email: julie.ouellet-pelletier.1@ulaval.ca

References

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