Is it necessary to catheterise the bladder routinely before gynaecological laparoscopic surgery?

Tang, Kwok Keung; Wong, Chung Kit; Lo, S. F.; Ng, T K

doi:10.1111/j.1479-828x.2005.00443.x

Cited by 15 publications

(15 citation statements)

References 14 publications

(19 reference statements)

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“…in a study to assess postoperative complications in 262 women who were randomized to either catheterization or non catheterization prior to gynecological laparoscopic surgery, the rate of postoperative uti after 7 days was 10% for the catheterized group compared to 3.8% in the noncatheterized group. 35 the rate in the noncatheterized group is more than an order of magnitude higher than the estimated population rates for us women (0.24% per week based on the nHanes data 32 ).…”

Section: Key Pointsmentioning

confidence: 70%

The epidemiology of urinary tract infection

2010

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Urinary tract infections (UTIs) are among the most common bacterial infections acquired in the community and in hospitals. In individuals without anatomical or functional abnormalities, UTIs are generally self limiting, but have a propensity to recur. Uropathogens have specialized characteristics, such as the production of adhesins, siderophores and toxins that enable them to colonize and invade the urinary tract, and are transmitted between individuals both through person-to-person contact and possibly via food or water. Although generally self limiting, treatment of UTIs with antibiotics leads to a more rapid resolution of symptoms and is more likely to clear bacteriuria, but also selects for resistant uropathogens and commensal bacteria and adversely affects the gut and vaginal microbiota. As uropathogens are increasingly becoming resistant to currently available antibiotics, it may be time to explore alternative strategies for managing UTI.

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Section: Key Pointsmentioning

confidence: 70%

The epidemiology of urinary tract infection

2010

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“…Although these procedures in addition to classic AH and LH would be anticipated to increase febrile morbidity, none of our patients experienced postoperative fever. The incidence of urinary tract infections has been shown to be higher in gynecological procedures where ureteral catheterization is employed [35]. We consider that employing diagnostic cystoscopy for the sole purpose of inspecting the bladder wall and observing ureteral jet streams might have prevented postoperative febrile morbidity in our study.…”

Section: Discussionmentioning

confidence: 99%

Which one is safer - performing a laparoscopic hysterectomy with a tissue fusion device involving diagnostic cystoscopy or traditional abdominal hysterectomy with ureteral dissection?

Yavuzcan¹,

Yıldız²,

Çağlar³

et al. 2013

Videosurgery and Other Miniinvasive Techniques

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IntroductionIt still remains an unanswered question whether, in the absence of gynecological malignancy and under elective conditions, to perform abdominal hysterectomy (AH), offering a safer approach, or to perform a laparoscopic hysterectomy (LH) procedure.AimWe aimed to compare LH operations performed with a tissue fusion device accompanied by intraoperative diagnostic cystoscopy with traditional AH operations involving bilateral ureteral dissection.Material and methodsThe integrity of the ureters, ureteral peristalsis and the diameter of the ureters were examined during AH by inspection. At the end of LH, the bladder wall was systematically evaluated by cystoscopy and a jet of urine spurting was noted from both ureteral orifices.ResultsThe operation time was longer in patients who underwent LH + CYS (p = 0.0001). The decline in hematocrit and hemoglobin levels in the postoperative period was significantly higher in patients who underwent AH + UD (p = 0.0001 and p = 0.002, respectively). No significant difference was found between the two groups in terms of ureteral injury, bowel injury or bladder injury (p = 0.378, p = 1.000 and p = 1.000, respectively). There was no statistically significant difference between the two groups in terms of mean body temperature and postoperative blood transfusion requirements (p = 0.051 and p = 0.210, respectively). Mean parenteral analgesic requirement and length of hospital stay were significantly different between the groups (p = 0.005 and p = 0.0001). No statistically significant difference was found between the two groups in terms of postoperative cardiopulmonary complications, re-operation rate or occurrence of genitourinary fistula (p = 1.000, p = 1.000 and p = 1.000, respectively).ConclusionsWe concluded that LH performed with a tissue fusion device involving diagnostic cystoscopy yields major and minor complication rates similar to safely performed AH operations preserving ureters.

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“…A necessidade de sondagem vesical e o tempo de permanên-cia com a sonda nas cirurgias ginecológicas ainda são assuntos controversos na literatura 6,23 , caracterizando-se, portanto, a necessidade de mais estudos sobre o tema.…”

Section: Discussionunclassified

“…Após a remoção do cateter, a bacteriúria é geralmente benigna, frequentemente assintomática e de resolução espontânea em pacientes hígidos. Ocasionalmente, persiste e acarreta complicações maiores 9,23 . Em um estudo envolvendo 1.497 pacientes submetidas à cateterização uretral, 235 desenvolveram infecção urinária hospitalar durante o período do estudo, sendo mais de 90% das pacientes assintomáticas, com apenas um caso de bacteremia 22 .…”

Section: Introductionunclassified

Fatores associados à bacteriúria após sondagem vesical na cirurgia ginecológica

Hinrichsen

Souza²,

Costa³

et al. 2009

Rev. Assoc. Med. Bras.

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RESUMOOBJETIVOS. Determinar a frequência e os principais fatores associados à bacteriúria após a sondagem vesical em mulheres submetidas à cirurgia ginecológica eletiva. MÉTODOS. Realizou-se um estudo do tipo coorte em mulheres submetidas à cirurgia ginecológica após sondagem vesical no Instituto de Medicina Integral Prof. Fernando Figueira, no período de janeiro a maio de 2007. As uroculturas foram coletadas até 24 horas após a retirada da sonda e 7/10 dias após a sondagem vesical. A análise estatística bivariada e multivariada foi realizada calculando-se a razão de risco e os seus intervalos de confiança a 95%. RESULTADOS. Foram incluídas no estudo 249 mulheres. A frequência de uroculturas positivas até 24 horas depois da retirada da sonda foi de 23,6%, diminuindo para 11,1% 7/10 dias após a sondagem. Destas, apenas 2,4% eram sintomáticas. Verificou-se menor risco de bacteriúria com 7/10 dias após a sondagem vesical quando a paciente referiu vulvovaginite tratada nos últimos três meses, não permanecendo estatisticamente significativa após a análise multivariada. Não houve associação significativa com idade, escolaridade, número de gestações, paridade, fase da vida reprodutiva, tipo e duração da cirurgia, tipo da anestesia, uso de antibiótico profilático, profissional que colocou a sonda e o tempo de permanência da sonda vesical. CONCLUSÃO. A frequência de bacteriúria foi de 23,6% e 11,1% com 24 horas e 7/10 dias, respectivamente. Não se encontrou associação significativa das variáveis pesquisadas com a bacteriúria evidenciada na urocultura com 7/10 dias.

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Is it necessary to catheterise the bladder routinely before gynaecological laparoscopic surgery?

Abstract: The policy of non-catheterisation before gynaecological laparoscopic surgery is safe and feasible. Although the reduction in UTI is insignificant, the overall postoperative urinary problems (urinary symptoms or UTI) are reduced significantly.

Cited by 15 publications

References 14 publications

The epidemiology of urinary tract infection

The epidemiology of urinary tract infection

Which one is safer - performing a laparoscopic hysterectomy with a tissue fusion device involving diagnostic cystoscopy or traditional abdominal hysterectomy with ureteral dissection?

Fatores associados à bacteriúria após sondagem vesical na cirurgia ginecológica

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