Calcified Foley Catheter and Vesicovaginal Fistula: A Case Report

Abstract

Calcification of indwelling urinary catheters is a known complication of prolonged urinary catheterization. It is caused by the formation of a bacterial biofilm, which promotes the accumulation of calcium deposits around the balloon. These deposits can lead to recurrent urinary tract infections, bladder stones, and, more rarely, bladder wall damage that can progress in the long term to a vesicovaginal fistula. We report the case of a 56-year-old woman living in a rural area who presented with persistent vaginal urinary incontinence. The patient reported having a urinary catheter that had been left in place for three years without being replaced, and whose distal portion had been severed by the patient herself in an attempt at self-removal. Urogenital examination revealed a calcified Foley catheter associated with a vesicovaginal fistula. Treatment consisted of transection of the distal portion of the catheter via the urethra, followed by extraction of the intravesical fragment and calculi through the fistulous opening. The fistula was repaired vaginally during the same procedure. The postoperative course was uneventful, with recovery of urinary continence upon catheter removal on day 21 and no recurrence at postoperative follow-up. This observation describes a rare complication of prolonged urinary catheterization and underlines the importance of regular follow-up and education of patients with long-term urinary catheters.