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Date of last update: 8/13/2017.

Forum Name: Urology Topics

Question: Pneumaturia after having a catheter in the ER

 Pneumaturia - Wed Dec 16, 2009 10:30 am

Okay, I have had what other doctors thought to be prostatitis, but it is seeming more and more likely that it is an enlargement of the prostate and not prostatitis. I am 22 years old and have had this enlargement for close to a year now. Last night I ended up in the emergency room because I had waited to long to urinate and could not. So at the ER they put in a Foley to drain the bladder. Today I have been urinating on my own, but not without pain and air coming out. I would like to know if after having a cath, is it normal to pass some air and have urethral pain, and for how long it should persist? I have passed air with the urine (usually after the urine is gone) it feels like shooting a large stream of air out. He did prescribe me some Flomax for the enlargement so I am hopeful that will help.

 Dr.M.Aroon kamath - Fri Dec 25, 2009 8:08 am

User avatar Hi Pneumaturia,
Pneumatuia is known to occur in cases of fistulous communication between the urinary tract and the intestinal tract (usually rectum or some part of the colon).

The usual causes are
- colorectal cancers,
- diverticulosis coli, &
- Crohn's disease.

Rarer cause quoted in the literature are
- emphysematous cystitis
- iatrogenic: Recent laparoscopic surgery (collateral damage),
diagnostic or surgical instrumentation,Renoalimentary fistulae
due to radiofrequency ablation or cryoablation).
- Foreign bodies in the bowel (eg,swallowed toothpicks,chicken
bones or other sharp objects).
- rectally or urethrally introduced objects (homosexuals & others)
- irradiation
- Congenital (isolated reports of a patient with an ectopic vas deferens opening into the bladder),
- emphysematous pyelonephritis,
- emphysematous pyelitis, and
- gas-forming renal abcesses.

The disease is often associated with female sex, diabetes mellitus,immunocompromised state, previous recurrent urinary tract infections, neurogenic bladder, urinary stasis and in transplant recipients.

The initial presentation in men may mimic prostatitis, especially if fever is present.

Pneumaturia's Pneumaturia certainly needs to be investigated in depth for the aforesaid possibilities.
Thank you pneumaturia for this very interesting post.
Best wishes!

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