The rigid ureteroscope-guided Seldinger technique: a novel and effective method of Foley catheter deployment in patients with challenging transurethral access

Transurethral Foley catheterization is the preferred method of bladder drainage in acute urinary retention. Various anatomical factors can make urethral access challenging, making perurethral catheterization impossible on occasions. In these instances, suprapubic catheterization or cystoscopic catheter deployment is often required. We describe an exceptionally difficult case in which transurethral catheterization remained unsuccessful despite cystoscopic visualization and establishing guidewire access. A Seldinger-like approach was used to safely deploy a Foley catheter over a semirigid ureteroscope, supporting the use of this alternative technique to secure bladder access while avoiding invasive suprapubic catheterization.