Abstract: Urethral catheterisation is a common and
safe procedure performed routinely. The small size
of the urethra in a child necessitates the use of an
infant feeding tube (Size 5 to 8 F) for catheterisation.
Knotting within the bladder is a rare complication with
significant morbidity often necessitating surgical or
endoscopic removal. Insertion of an excessive length
of tube contributes to coiling and knotting. We report
an instance of knotting of an infant feeding tube in
the proximal penile urethra of a 4 year-old male child
requiring urethrotomy to remove it. Awareness of the
risk and proper technique can reduce this complication
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