Compression of femoral vein by the strap of a urine-collecting device in aspinal cord injury patient

Objective: To report an unusual cause of femoral vein compression in a spin al cord injury (SCI) patient. Design: A case report of a SCI patient in whom the strap of a urinal produc ed compression of femoral vein. Setting Regional Spinal Injuries Centre, Southport, England. Subject: A 65-year old male, who had sustained paraplegia at T-IO level 33 years ago, attended the spinal unit for a routine follow-up intravenous uro graphy (IVU). He was wearing a urinal, which was held tightly over the peni s by means of two straps coursing over the inguinal regions. Main outcome measures: IVU was performed by injecting 50 ml of Ultravist-30 0 via a 23-gauge butterfly needle inserted in a vein over the dorsum of the left foot. After completion of the injection, an X-ray of the pelvis was t aken to evaluate the right hip. This showed contrast in the vena profunda f emoris, circumflex femoral veins and inter-muscular veins with evidence of compression of proximal femoral vein. Results: It was suspected that the strap holding the urinal was causing com pression of the femoral vein. Therefore, a venogram was performed 5 days la ter, when the patient had discarded the urinal and the straps. This showed free flow of contrast through the left femoral and iliac veins. Conclusion: Compression of femoral vein by a strap holding the urinal was d iscovered serendipitously in this patient during a routine follow-up. Physi cians and health professionals should bear in mind this rare complication w hen examining spinal cord injury patients who use this type of urine collec ting device, and discuss with them alternative methods for urinary drainage .