A Unique Complication of Urethral Catheterization

Pubic Hair Associated With Struvite Bladder Calculi

Sarah Perz, MS; Chandy Ellimoottil, MD; Manoj Rao, MD; Larissa Bresler, MD


Urol Nurs. 2013;33(5):233-235. 

In This Article


It is essential for physicians, nurses, and other clinicians to instruct patients on proper hygiene during self-catheterization (for CIC or routine in dwelling Foley placement). This may minimize pubic hair induced bladder calculi. The complication of Foleyassociated, hair-induced bladder calculi has almost exclusively been reported in males. This gender discrepancy may be attributed to the need for male patients to use more lubricating jelly when inserting the catheter, which can increase the probability that a pubic hair will adhere to the catheter prior to insertion (Amendola et al., 1983). Patients who were instructed to shave their pubic hair often and be cognizant of the possibility of hair sticking to the catheter did not experience recurrence in one study (Amendola et al., 1983).

Immediately post-treatment, there was no evidence of stone fragments left behind that could possibly serve as a nidus in the future. RS was again instructed by the staff on proper sterile technique and hygiene to prevent stone recurrence. It was speculated that his stones were secondary to a foreign body; thus, RS was advised not to restrict his diet, nor was an extensive metabolic workup undertaken at the time. Eight months following his procedures, there has been no evidence of recurrence. However, a standard metabolic workup for a patient with recurrent calculi would be conducted if recurrent calculi become a chronic problem or stones were found without an obvious foreign body nidus.

As a result of this case, the urologic nurses in our practice were reminded to stress the importance of sterile technique and trimming or shaving pubic hair to all patients practicing CIC or changing their own indwelling urinary catheters. This case is an excellent example of the value of patient education in preventing potentially serious complications associated with urinary catheters.