Differential Diagnosis for Bladder Scan Showing 300 cc with No Urine Output from Foley Catheter

• Single Most Likely Diagnosis
  • Kinked or Obstructed Foley Catheter: This is the most straightforward explanation for the discrepancy between the bladder scan and the urine output. A kink or obstruction in the catheter would prevent urine from draining out, despite the bladder being full.
• Other Likely Diagnoses
  • Clotted Foley Catheter: Blood clots can form in the catheter, blocking urine flow. This is common in patients with bleeding disorders, after surgery, or with urinary tract infections.
  • Foley Catheter Malposition: If the catheter is not properly positioned within the bladder, it may not drain urine effectively.
  • Urethral Stricture or Blockage: A narrowing or blockage of the urethra could prevent urine from flowing out through the catheter.
• Do Not Miss Diagnoses
  • Bladder Perforation: Although less likely, a perforated bladder could lead to urine leaking into the abdominal cavity instead of into the catheter. This is a medical emergency.
  • Ureteral Obstruction: Blockage of one or both ureters could prevent urine produced by the kidneys from reaching the bladder, leading to a discrepancy between bladder volume and catheter output.
• Rare Diagnoses
  • Foley Catheter Balloon Obstruction: In rare cases, the balloon used to secure the catheter in place might obstruct the catheter's lumen, preventing urine flow.
  • Bladder Neck Contracture: Scarring at the bladder neck could impede urine flow, though this would typically be associated with other symptoms and a history suggestive of the condition.
  • Intra-abdominal Shunt or Fistula: An abnormal connection between the bladder and another organ or the abdominal wall could divert urine flow away from the catheter, though this would be extremely rare and likely associated with significant other symptoms.