Timing of urinary catheter removal after uncomplicated total abdominal hysterectomy: a prospective randomized trial

Ahmed, Marwa F.; Ali, Waleed; Atwa, Khaled A.; Metwally, Lobna

doi:10.1016/j.ejogrb.2014.02.038

Cited by 62 publications

(75 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Direct catheter removal has also been associated with early mobilisation after surgery. 6,16 This was also observed in our study; women with ICR mobilised significantly earlier compared with women with DCR, with a difference in medians of 15 hours. Patients with ICR are forced to get out of bed to void, which is a positive side effect of this regimen because early mobilisation has been associated with quicker recovery and decreased morbidity.…”

Section: Discussionsupporting

confidence: 87%

“…Indeed, the few available studies on this topic all favour immediate removal after different types of hysterectomy. 4,6,16 The potential drawback of immediate catheter removal is the increased risk of urinary retention, which has been reported to be up to 34% after LAVH. 4 The retention rate in our study was in line with a prospective cohort study that demonstrated a retention rate of 14% after analysing 140 women undergoing LH with ICR.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Immediate versus delayed removal of urinary catheter after laparoscopic hysterectomy: a randomised controlled trial

Sandberg

Twijnstra

Meir

et al. 2019

BJOG

View full text Add to dashboard Cite

Objective To evaluate if immediate catheter removal ( ICR ) after laparoscopic hysterectomy is associated with similar retention outcomes compared with delayed removal ( DCR ). Study design Non‐inferiority randomised controlled trial. Population Women undergoing laparoscopic hysterectomy in six hospitals in the Netherlands. Methods Women were randomised to ICR or DCR (between 18 and 24 hours after surgery). Primary outcome The inability to void within 6 hours after catheter removal. Results One hundred and fifty‐five women were randomised to ICR ( n = 74) and DCR ( n = 81). The intention‐to‐treat and per‐protocol analysis could not demonstrate the non‐inferiority of ICR : ten women with ICR could not urinate spontaneously within 6 hours compared with none in the delayed group (risk difference 13.5%, 5.6–24.8, P = 0.88). However, seven of these women could void spontaneously within 9 hours without additional intervention. Regarding the secondary outcomes, eight women from the delayed group requested earlier catheter removal because of complaints (9.9%). Three women with ICR (4.1%) had a urinary tract infection postoperatively versus eight with DCR (9.9%, risk difference −5.8%, −15.1 to 3.5, P = 0.215). Women with ICR mobilised significantly earlier (5.7 hours, 0.8–23.3 versus 21.0 hours, 1.4–29.9; P ≤ 0.001). Conclusion The non‐inferiority of ICR could not be demonstrated in terms of urinary retention 6 hours after procedure. However, 70% of the women with voiding difficulties could void spontaneously within 9 hours after laparoscopic hysterectomy. It is therefore questionable if all observed urinary retention cases were clinically relevant. As a result, the clinical advantages of ICR may still outweigh the risk of bladder retention and it should therefore be considered after uncomplicated laparoscopic hysterectomy. Tweetable abstract The advantages of immediate catheter removal after laparoscopic hysterectomy seem to outweigh the risk of bladder retention.

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Immediate versus delayed removal of urinary catheter after laparoscopic hysterectomy: a randomised controlled trial

Sandberg

Twijnstra

Meir

et al. 2019

BJOG

View full text Add to dashboard Cite

show abstract

“…The risks of postoperative urinary retention and over-distension need to be weighed against UTI risk. Removal immediately following surgery was associated with increased urinary retention, and removal after 24 hours with increased risk of UTI; removal at 6 hours resulted in the fewest adverse events (15). Strategies to decrease the length of time associated with catheterization may need to be carefully considered in each case but are promising areas to decrease this morbidity.…”

Section: Commentmentioning

confidence: 99%

Cranberry juice capsules and urinary tract infection after surgery: results of a randomized trial

Foxman

Cronenwett

Spino

et al. 2015

American Journal of Obstetrics and Gynecology

View full text Add to dashboard Cite

Objective The risk of urinary tract infection (UTI) among women undergoing elective gynecologic surgery where a catheter is placed is high: 10 to 64% following catheter removal. We conducted the first randomized, double-blind, placebo-controlled trial of the therapeutic efficacy of cranberry juice capsules in preventing UTI post surgery. Study Design We recruited patients from a single hospital between August 2011 and January 2013. Eligible participants were undergoing elective gynecologic surgery that did not involve a fistula repair or vaginal mesh removal. 160 patients were randomized and received two cranberry juice capsules two times a day, equivalent to two 8-ounce servings of cranberry juice, for 6 weeks after surgery, or matching placebo. The primary endpoint was the proportion of participants who experienced clinically-diagnosed and treated UTI with or without positive urine culture. Kaplan-Meier plots and logrank tests compared the two treatment groups. Results The occurrence of UTI was significantly lower in the cranberry treatment group compared to the placebo group (15/80 (19%) versus 30/80 (38%); OR=0.38; 95% CI: 0.19, 0.79; p=0.008). After adjustment for known confounders, including frequency of intermittent self-catheterization in the post- operative period, the protective effects of cranberry remained (OR=0.42; 95% CI: 0.18, 0.94). There were no treatment differences in the incidence of adverse events; including gastrointestinal upset (56% vs. 61% for cranberry vs. placebo). Conclusions Among women undergoing elective benign gynecologic surgery involving urinary catheterization, use of cranberry extract tablets during the postoperative period reduced the rate of UTI by half.

show abstract

“…Çalışma sonucunda, kateteri cerrahi sonrası ilk 6 saat içinde çıkarılan hastanın, diğer hastaya göre daha az üriner enfeksiyona maruz kaldığı bulunmuştur. 63 …”

Section: üRiner Drenajunclassified

A New Approach to Evidence Based Practices in Gynecological Surgery: ERAS Protocol and Nursing

Aksoy¹,

Yılmaz²

2018

Turkiye Klinikleri J Nurs Sci

View full text Add to dashboard Cite

Timing of urinary catheter removal after uncomplicated total abdominal hysterectomy: a prospective randomized trial

Cited by 62 publications

References 16 publications

Immediate versus delayed removal of urinary catheter after laparoscopic hysterectomy: a randomised controlled trial

Immediate versus delayed removal of urinary catheter after laparoscopic hysterectomy: a randomised controlled trial

Cranberry juice capsules and urinary tract infection after surgery: results of a randomized trial

A New Approach to Evidence Based Practices in Gynecological Surgery: ERAS Protocol and Nursing

Contact Info

Product

Resources

About