A randomised controlled trial comparing immediate versus delayed catheter removal following vaginal prolapse surgery
File(s)
Supporting information
Supporting information
Author(s)
Bray, R
Cartwright, R
Digesu, A
Fernando, R
Khullar, V
Type
Journal Article
Abstract
OBJECTIVE: It is unclear if any catheterisation is necessary after vaginal surgery for pelvic organ prolapse. The aim of this study was to determine if indwelling catheterisation is necessary after these procedures.
STUDY DESIGN: A randomised controlled trial of immediate post-operative removal of catheter compared to a suprapubic catheter (SPC) after vaginal prolapse surgery. In the Suprapubic group the catheter was left on free drainage until a voiding trial was commenced at 48hrs. Women in the immediate removal group underwent in/out catheterisation only if they had not voided by 8hrs after surgery to ensure the bladder did not over-distend.
RESULTS: 55% (n=17) of patients in the immediate removal group did not require catheterisation postoperatively. A further 13 (42%) patients only required one in/out catheterisation 8 hours post operatively. In the immediate removal group duration of catheterisation was significantly shorter (median 0hrs, IQR 0-8 hours, range 0-16 hours) vs (6 days (IQR 2-8 days, range 2-19 hours) p=0.001). The duration of hospital stay (7 days (range 3-16) vs. 9 (range 3-27) p=0.014), day of first mobilisation (Day 1, range 0-2, vs. Day 2, range 1-4, p=0.001), and rate of Symptomatic bacturia (16% vs. 52%, p<0.01) were all significantly better with immediate catheter removal.
CONCLUSIONS: After vaginal surgery for pelvic organ prolapse, the majority of patients do not require extended catheterisation. Early removal of a catheter reduces urinary tract infection and significantly decreases hospital stay. Such a policy should result in improved patient satisfaction and reduced hospital costs.
STUDY DESIGN: A randomised controlled trial of immediate post-operative removal of catheter compared to a suprapubic catheter (SPC) after vaginal prolapse surgery. In the Suprapubic group the catheter was left on free drainage until a voiding trial was commenced at 48hrs. Women in the immediate removal group underwent in/out catheterisation only if they had not voided by 8hrs after surgery to ensure the bladder did not over-distend.
RESULTS: 55% (n=17) of patients in the immediate removal group did not require catheterisation postoperatively. A further 13 (42%) patients only required one in/out catheterisation 8 hours post operatively. In the immediate removal group duration of catheterisation was significantly shorter (median 0hrs, IQR 0-8 hours, range 0-16 hours) vs (6 days (IQR 2-8 days, range 2-19 hours) p=0.001). The duration of hospital stay (7 days (range 3-16) vs. 9 (range 3-27) p=0.014), day of first mobilisation (Day 1, range 0-2, vs. Day 2, range 1-4, p=0.001), and rate of Symptomatic bacturia (16% vs. 52%, p<0.01) were all significantly better with immediate catheter removal.
CONCLUSIONS: After vaginal surgery for pelvic organ prolapse, the majority of patients do not require extended catheterisation. Early removal of a catheter reduces urinary tract infection and significantly decreases hospital stay. Such a policy should result in improved patient satisfaction and reduced hospital costs.
Date Acceptance
2017-01-13
Citation
European Journal of Obstetrics and Gynecology and Reproductive Biology
ISSN
0028-2243
Publisher
Elsevier
Journal / Book Title
European Journal of Obstetrics and Gynecology and Reproductive Biology
Publication Status
Accepted