Purple urinary bag syndrome: what every primary healthcare provider should know

Description 

A 70-year-old man with bladder outlet obstruction due to benign prostatic hyperplasia who was on urethral (Foley) catheter presented to us with complaint of purple discoloration of his urine collection bag (figure 1). He had history of multiple failed trials of voiding without catheter. Along with this he had constipation for which he was already taking laxatives. He was on Foley catheter for 6 months (which was changed every 3 weeks) and now was planned for transurethral resection of prostate (TURP). He was alarmed by this discolouration. His urine was clear but the urine collection bag had a purple discolouration. On microscopic examination, his urine had plenty of leucocytes and his urinary pH was 8. His urine culture was positive for Escherichia coli (>10⁵ colony forming units/mL). His serum creatinine was 0.9 mg/dL. A diagnosis of purple urinary bag syndrome (PUBS) was made. His catheter was replaced...

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