Postoperative Voiding Dysfunction: The Preferred Method for Catheterization.

Area of Science:

• Urology
• Gynecologic Surgery
• Patient-Centered Care

Background:

• Postoperative voiding dysfunction is a potential complication following pelvic organ prolapse (POP) surgery.
• Bladder drainage management options include clean intermittent self-catheterization (CISC), transurethral indwelling catheterization (TIC), and suprapubic tube (SPT).
• Patient preference and satisfaction are crucial factors in selecting appropriate catheterization methods.

Purpose of the Study:

• To determine patient preference for catheter type after POP surgery.
• To compare patient satisfaction, uroflowmetry, and infection rates among different bladder drainage methods.
• To evaluate the impact of patient choice on outcomes following POP surgery.

Main Methods:

• A prospective study involving 150 patients scheduled for POP surgery between 2012 and 2016.
• Patients were informed about catheter options (CISC, TIC, SPT) preoperatively and their choice was recorded.
• Postoperative assessments included voiding dysfunction evaluation, catheter use duration, satisfaction questionnaires, uroflowmetry, and urine cultures.

Main Results:

• 86% of patients chose SPT, significantly higher than CISC (6.7%) and TIC (7.3%).
• SPT use was associated with significantly better catheter satisfaction scores at 1 week post-surgery (P = 0.005).
• SPT also demonstrated lower rates of high post-void residual (PVR) (13% vs. 33% for CISC, 25% for TIC; P = 0.002) and positive urine cultures (24% vs. 33% for CISC, 50% for TIC; P = 0.05) at week 1.

Conclusions:

• Patients strongly prefer suprapubic tubes (SPT) for bladder drainage after POP surgery.
• SPT offers superior patient satisfaction, improved uroflowmetry results, and reduced infection rates compared to CISC and TIC.
• Incorporating patient preference into clinical decision-making can enhance outcomes for voiding dysfunction management post-POP surgery.