ABSTRACT
To assess usefulness of flexible cystoscope in difficult male urethral catheterization. Fauji Foundation Hospital and Maryam Memorial Hospital, Rawalpindi during a period of four years. In a consecutive series of thirty patients with acute urinary retention and initial difficulty in urethral catheterization, a flexible cystoscope and a guide wire was used to insert the Foley's catheter. Ten patients [33.3%] presented with acute urinary retention due to benign enlargement of prostate. Five patients [16.6%] required re-catheterization following unsuccessful trial after transurethral resection of prostate. Four patients [13.3%] had carcinoma of prostate. This technique was used five times [16%] to catheterize prior to intravesical instillation of cytotoxic drugs. Two patients [6.6%] had bladder neck distortion due to transitional cell carcinoma of bladder, one [3.3%] had an extravesical haematoma and another one [3.3%] had massive post traumatic clot retention. The procedure was successful in 86.7% of the cases. Difficulty to negotiate the urethra was faced in cases of urethral strictures [6.6%]. Flexible cystoscope is a safe, quick and effective method for difficult urethral catheterization in male patients