The Optimal Time to Remove Urinary Catheters in Laparoscopic Partial Nephrectomy, Laparoscopic Adrenalectomy or Laparoscopic Nephrectomy

Abstract

Objective To explore the best time to remove the indwelling urinary catheters after laparoscopic partial nephrectomy (LPN), laparoscopic adrenalectomy (LA) or laparoscopic nephrectomy (LN) so as to reduce the indwelling time of nontherapeutic catheters and thus reduce postoperative complications and enhance recovery. Methods We included 140 patients who have undergone laparoscopic partial nephrectomy, laparoscopic adrenalectomy or laparoscopic nephrectomy and received indwelling urinary catheters during the operation in the Department of Urology in our hospital from January 2019 to December 2019. The patients were averagely randomized into control group and observation group. The indwelling urinary catheters in the control group were kept for 3 d and then nurses removed the catheters following the doctor's advice. In the observation group nurses removed the urinary catheters following the removal procedures after assessing the indications of removal of urinary catheters and necessity of keeping the catheters. After operation, the time of keeping the indwelling urinary catheters, first leaving bed, first passage of gas by anus, average hospital stay, occurrence of constipation and score of painful urination were compared between the two groups. Results In the observation group, after operation, the average time of keeping the indwelling urinary catheters is 7.94±1.54 h, the average time of first leaving bed activity is 18.65±6.14 h, first passage of gas by anus is 16.18±2.44 h, and the average hospital stay is 5.71±1.93 d. Compared with control group, there is a significant difference (P< 0. 05). There is also a significant difference in the occurrence of constipation between the two groups with 6 cases in control group but 0 in observation group (χ 2 =4.353, P=0.037). Patients in both groups have urination discomfort to different degrees and the score of pain is significantly different between the two groups (χ 2 =5.079, P=0.024). Conclusions The indwelling urinary catheters for intraoperative needs are advised to remove within 12 h after laparoscopic partial nephrectomy, laparoscopic adrenalectomy or laparoscopic nephrectomy, which can enhance patients' comfort level and recovery, reduce length of stay and hospitalization costs, and save medical costs.