Frequent Urethrovesical Foreign Object Insertion: Resource Utilization and Outcomes.

OBJECTIVE

To evaluate characteristics, healthcare utilization, and outcomes among patients with frequent presentations of urethrovesical foreign objects (UFO).

METHODS

We queried the California Department of Health Care Access and Information data (2008-2016) to identify patients with a primary UFO diagnosis. Patients were categorized as infrequent (<3) or frequent (≥3) presenters and followed for urethral stricture/stenosis. A multivariable logistic model identified factors associated with frequent presentation.

RESULTS

We found 1589 UFO encounters corresponding to 851 and 50 infrequent and frequent presenters, respectively. Frequent presenters accounted for 629 (40%) of total encounters, with a median of 4 encounters (IQR 3-11, range 3-135) and interval of 21 days (IQR 7-73) between episodes. Frequent presenters more commonly required hospitalization compared to infrequent presenters (31% vs 19%; P<.001) and discharged to custodial care services (22% vs 2.5%; P<.001). Factors associated with frequent presentation included male sex (OR 5.9, 95% CI 3.7-9.3), age 25-44 years (ref: ≤12; OR 5.3, 95% CI 1.4-20.4), White race (ref: Non-White; OR 2.6, 95% CI 1.9-3.7), mental illness (OR 4.6, 95% CI 3.6-5.9), incarceration (OR 7.1, 95% CI 4-12.5), and social deprivation (OR 3.6, 95% CI 2.5-5.3). Frequent presenters showed higher rates of urethral stricture/stenosis (30% vs 4.7%; P=.017).

CONCLUSION

Frequent presenters account for a large share of UFO encounters and drive significant healthcare utilization and have a higher risk for urethral stricture.