Urinary Catheter Management Approaches Among Women Undergoing Benign Gynecologic Surgery: A Randomized Trial

Female Pelvic Med Reconstr Surg. 2020 Dec 1;26(12):e73-e77. doi: 10.1097/SPV.0000000000000781.

Abstract

Objective: The objective of this study was to identify differences in voiding trial success rates between delayed (postoperative day 1) and day of surgery catheter removal ("fast track") among women undergoing benign gynecologic surgery. Rates of urinary tract infection, patient satisfaction, and lower urinary tract symptoms were compared between catheter management schemes.

Methods: Women undergoing benign gynecologic surgery were randomized to either "conventional" delayed urinary catheter care removal on postoperative day 1 or day of surgery catheter removal (fast track) 4 hours after surgery. Subjects were asked to complete a brief survey recording bladder function before and during their hospitalization and satisfaction with their catheter management. Subjects were contacted by phone 2 to 3 weeks after the index surgery to survey their bladder function including symptoms (eg, dysuria) or treatment indicative of a bladder infection.

Results: The median dwell time for Foley catheters in the "fast-track" group was 8.15 hours (SD = 375 minutes), whereas the median dwell time in the conventional group was 20.6 hours (SD = 265 minutes), which was significantly different (P < 0.001). Overall, 153 (93%) patients passed their voiding trial with significantly more patients passing their voiding trial in the conventional management group (P = 0.01). There was no difference in the Urogenital Distress Inventory scores at 2 weeks between catheter management cohorts (P = 0.81).

Conclusions: Foley dwell time is significantly reduced in the fast-track cohort. Voiding trial failure is higher with same-day catheter removal but that rate of failure rate is low. Patient satisfaction, the Urogenital Distress Inventory score, and postoperative urinary tract infection rates are not significantly different between cohorts.

Trial registration: ClinicalTrials.gov NCT03127280.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Device Removal* / adverse effects
  • Device Removal* / methods
  • Female
  • Gynecologic Surgical Procedures* / adverse effects
  • Gynecologic Surgical Procedures* / methods
  • Humans
  • Lower Urinary Tract Symptoms* / diagnosis
  • Lower Urinary Tract Symptoms* / etiology
  • Lower Urinary Tract Symptoms* / prevention & control
  • Middle Aged
  • Outcome and Process Assessment, Health Care
  • Patient Reported Outcome Measures
  • Patient Satisfaction
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / prevention & control
  • Postoperative Complications* / psychology
  • Time-to-Treatment
  • Urinary Catheterization* / adverse effects
  • Urinary Catheterization* / instrumentation
  • Urinary Catheterization* / methods
  • Urinary Catheters
  • Urinary Retention* / diagnosis
  • Urinary Retention* / etiology
  • Urinary Retention* / prevention & control
  • Urinary Tract Infections* / diagnosis
  • Urinary Tract Infections* / etiology
  • Urinary Tract Infections* / prevention & control

Associated data

  • ClinicalTrials.gov/NCT03127280