Urinary tract catheterization protocols following total joint arthroplasty.

Area of Science:

• Urology
• Orthopedic Surgery
• Infectious Disease

Background:

• Urinary tract infections (UTIs) are a common complication following total joint arthroplasty.
• Catheterization protocols vary, potentially impacting infection rates and patient comfort.

Purpose of the Study:

• To compare the efficacy and safety of three different urinary catheterization protocols in total joint arthroplasty patients.
• To evaluate the incidence of urinary tract infections, catheterization frequency, and subsequent urinary tract manipulations across protocols.

Main Methods:

• A prospective study involving 601 total joint arthroplasty patients divided into three groups.
• Group 1: "As needed" intermittent catheterization.
• Group 2: Initial in-and-out catheterization followed by a closed drainage system if needed.
• Group 3: Intraoperative sterile anchoring of a closed drainage system for ≤48 hours.

Main Results:

• No statistically significant difference in postoperative urinary tract infection rates was observed between the three groups (Group 1: 1 UTI, Group 2: 2 UTIs, Group 3: 0 UTIs).
• Group 3 required fewer catheterizations and subsequent manipulations compared to Group 1.
• The protocol in Group 3 was associated with greater patient convenience.

Conclusions:

• Different urinary catheterization protocols demonstrate comparable UTI rates in total joint arthroplasty patients.
• Intraoperative sterile anchoring of a closed drainage system for a limited duration (≤48 hours) is a viable and convenient option.