Multi-centre, prospective evaluation of the Seldinger technique for difficult male urethral catheter insertions by non-urology trained doctors

Abstract

Objective: To evaluate the safety and effectiveness of the Seldinger technique by non-urology trained (NUT) doctors for difficult male indwelling urinary catheter (IDC) insertions. Patients and Methods: In all, 115 patients and 57 participating NUT doctors were recruited by the urologist or urology registrar, when contacted in regards to failed IDC insertion. The successful passage of an IDC by the NUT doctors using the Seldinger technique with a straight, hydrophilic guidewire was assessed in our prospective, multicentre evaluation. Instruction of this technique was via bedside teaching by the urology registrar or via video media. Results: The 115 patients, involving 57 NUT doctors, were prospectively evaluated across four sites; 93% (107/115) of cases had successful placement of an IDC with the Seldinger technique by a NUT doctor. No complications with the Seldinger technique were recorded. In 80 patients (69.6%), the technique was successfully performed by a NUT doctor without attendance by a urologist or urology registrar, with instruction provided from video media or prior bedside teaching by the urology registrar. Conclusions: Our study is the first to validate the safety and effectiveness of the Seldinger technique for difficult male IDC insertion performed by NUT doctors. This technique can be taught via video education and thus has important implications for health services where urological support is not readily available.