Seminal vesicle abscess with orchitis and emphysematous cystitis following traumatic urethral injury from accidental urinary catheter dislodgement.

Abstract

Background: Indwelling urinary catheters are widely used in hospitalized patients but can be inadvertently dislodged due to trauma, leading to complications such as catheter-associated urinary tract infections and urological injuries.

Case report: An 87-year-old man developed a seminal vesicle abscess (SVA) caused by Pseudomonas aeruginosa following urethral injury due to accidental urinary catheter dislodgement. The patient presented with hematuria and penile bleeding following dislodgement of the urinary catheter, and subsequently developed fever and a urinary tract infection. Computed tomography revealed contrast enhancement in the left seminal vesicle and left testis, as well as emphysematous cystitis. Magnetic resonance imaging confirmed an abscess in the left seminal vesicle. Urine cultures identified P. aeruginosa as the causative organism. The patient was successfully treated with intravenous ciprofloxacin without the need for surgical drainage and was subsequently transferred to another facility.

Conclusions: Traumatic urinary catheter removal increases the risk of urethral injury and infection; therefore, appropriate measures to prevent catheter dislodgement are essential. Additionally, in urinary tract infections following catheter-related urethral injury, the possibility of progression to an SVA should be considered. Early imaging-based diagnosis, targeted antibiotic therapy, and drainage, when necessary, are crucial for improving patient outcomes.