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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17669
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I would be very grateful professional opinion on the

Resolved Question:

I would be very grateful for your professional opinion on the following:
My elderly relative (in his 90's but very healthy) sadly died recently following an operation to pin her fractured hip. The operation seemed to go well, but around one week later he developed aspiration pneumonia and then multiple organ failure.
During the post operative phase, he continually asked for the urine catheter to be removed. The nurses informed us it had to stay in place although little urine was flowing through it. The evening he died, I asked the nurse to check the catheter again - it was found to be blocked, his bladder distended and almost one litre of urine drained out after unblocking.
My questions are:
1. Could the blocked catheter have caused kidney failure, which then led to multiple organ failure?
2. I hate to feel he was in pain from his bladder or kidneys - would he have been in pain - he was on constant morphine for his hip fracture.
Your views on both would be much appreciated
Many thanks
Submitted: 10 months ago.
Category: Medical
Expert:  Dr. D. Love replied 10 months ago.
Hello from JustAnswer. I am sorry for your loss. 1. It is possible that a blockage of outflow of the bladder could cause kidney failure, and after kidney failure occurs, it can lead to other organ failure. However, there typically would be much more than one liter of urine when the blockage is relieved, so it is not likely in this case. It is far more likely that the multiple organ failure was related to respiratory failure or sepsis from the aspiration. 2. Although the liter of urine that was in the bladder is not the amount seen with kidney failure, it is possible that this amount of bladder distention could have caused pain or cramping. But the morphine that was being given for the hip fracture would relieve pain anywhere in the body, so he likely was not feeling any pain from the bladder distention. If I can provide any clarification, please let me know.
Customer: replied 10 months ago.
Thank you very much, that is reassuring. For clarification, how long before kidney failure might set in (if that is what happens, and it doesn't sound likely from your answer)? Does it happen over a period of days or weeks following a catheter blockage. My relative was using the catheter for around one week before he died, perhaps the catheter was blocked for part of that time, 5 days maybe. Could this short period of time cause kidney failure or is it unlikely..?I had no idea the bladder could hold more than a litre of urine..!
Expert:  Dr. D. Love replied 10 months ago.
There is no set amount of time, because it would depend upon how quickly urine is being made and overfills the bladder, but it usually will take several days. If someone is not making much urine, though, it may take much longer. The issue in this case is not the amount of time that the catheter may have been blocked, but that there would typically be much more urine that drains once the blockage is relieved. Most people that have voluntary bladder control will empty the bladder long before one liter of urine accumulates, but the bladder can be forced to hold much more when it cannot empty. The bladder has to overfill before the urine will back up further to adversely affect the kidneys. So, when this happens, and the blockage is relieved, it is not just urine from the bladder that drains, but urine that has also backed up into the tubes to the kidney, the ureters.
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17669
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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