A randomized controlled trial comparing short versus long-term catheterization after uncomplicated vaginal prolapse...

Area of Science:

• Urogynecology
• Surgical Outcomes
• Infectious Disease Prevention

Background:

• Routine urinary catheterization post-vaginal prolapse surgery aims to prevent urine retention but risks urinary tract infection (UTI), delayed ambulation, and prolonged hospital stays.
• Optimizing catheter management is crucial for minimizing complications and improving patient recovery after prolapse surgery.

Purpose of the Study:

• To evaluate the optimal timing for urinary catheter removal following vaginal prolapse surgery to minimize catheter-related complications.
• To compare outcomes between early (1st postoperative day) and late (4th postoperative day) catheter removal.

Main Methods:

• A randomized controlled trial involving 200 patients undergoing vaginal prolapse surgery.
• Patients were randomized into two groups: Group I (catheter removal on day 1) and Group II (catheter removal on day 4).
• Recatheterization was performed if patients could not void or had >150 mL residual urine; urine cultures were obtained upon catheter removal.

Main Results:

• Early catheter removal (Group I) resulted in significantly shorter catheterization duration (1.64 vs 4.09 days) and hospital stay (by 1.2 days).
• Group I had a significantly higher incidence of urine retention or >150 mL residual urine (OR 3.10).
• Group I experienced a significantly lower incidence of urinary tract infection (OR 0.10).

Conclusions:

• Early urinary catheter removal after vaginal prolapse surgery offers advantages including a lower incidence of urinary tract infection and shorter hospital stays.
• This approach is associated with an increased risk of urine retention and the need for recatheterization.