We describe the case of a 76-year-old male who presented with a retained Foley catheter. On the initial attempt to deflate the Foley catheter with a syringe attached to the inflation port, no fluid was aspirated. Using a flexible cystoscope passed alongside the catheter, the balloon was punctured under direct vision with an intravesical needle passed through the cystoscope working channel. We discuss this innovative and safe method for balloon puncture via the transurethral route that can be achieved in the urology outpatient or endoscopy suite.
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