Iatrogenic Urinary Catheter Migration into the Left Lumbar Ureter in an Active Gynecologic Oncology Patient: The 6th Worldwide Case Report and Comprehensive Literature Review
Abstract
Introduction: Migration of a transurethral urinary catheter into the upper urinary tract is one of the rarest and least recognized iatrogenic complications in urology. To date, fewer than fifty cases have been reported in the world literature, occurring almost exclusively in female patients with conditions reducing bladder capacity. We report here the 6ᵗʰ case involving a urethral catheter that migrated into the left lumbar ureter in a patient with metastatic endometrial adenocarcinoma undergoing chemo-immunotherapy (Paclitaxel–Carboplatin–Dostarlimab), an oncological context never previously described in this type of complication. Case Report: A 65-year-old woman with metastatic endometrial adenocarcinoma on active systemic treatment, complicated by proximal pulmonary embolism. During routine replacement of her indwelling urinary catheter, the patient developed acute left-sided flank pain associated with paradoxical urinary urgency despite a catheter in place. Physical examination revealed a hard, painful hypogastric mass corresponding to the pelvic tumor. Laboratory workup showed a major inflammatory syndrome (CRP 290 mg/L, leukocytosis at 15,500/mm³), anemia (Hb 8.1 g/dL), acute renal failure (creatinine 17 mg/L), and a urinary tract infection with Escherichia coli. Bladder scan showed 487 mL post-void residual despite the catheter in place. The non-contrast CT of the abdomen and pelvis was pathognomonic: a large pelvic mass measuring 147 × 123 × 141 mm with the catheter…
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