Early catheter removal following transurethral prostatectomy: a study of 431 patients

To assess and review catheter removal on the first day after transurethral prostatectomy.

The study included 431 consecutive patients who underwent transurethral prostatectomy between 2000 and 2003 at a Scarborough General Hospital, Toronto, Canada. The equipment used was a standard resectoscope with a regular loop. No roller ball or other gadget was used. The cutting and coagulation electrical variables were standard at 160 and 60 W for the generator used. The decision to remove the catheters was based on normal vital signs, adequate urine output, absence of clots and acceptable color of the catheter effluent.

Catheters were removed in 415 (96.3%) patients on postoperative day 1. Of the 415 patients 332 (80.0%) were discharged on the same day. The criteria for catheter removal on postoperative day 1 were not met in 16 (3.7%) patients and the mean indwelling catheter time was 4.8 +/- 2.4 days and the mean length of hospital stay after surgery was 6.2 +/- 3.3 days. For the entire group, the mean indwelling catheter time was 1.1 +/- 0.8 days and the mean length of hospital stay after surgery was 1.6 +/- 1.5 days. Risk factors which predicted delayed removal were age, postoperative bleeding and several comorbidities, that is coronary heart disease, renal insufficiency and Alzheimer's disease.

Removal of the catheter on the first postoperative day after transurethral prostatectomy seems to be feasible, safe and cost-effective without increasing significant morbidity in selected patients.