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Early catheter removal after pelvic floor reconstructive surgery: a randomized trial
Charelle M Carter-Brooks1, Halina M Zyczynski2, Pamela A Moalli2
1Division of Urogynecology and Reconstructive Surgery, Department of Obstetrics, Gynecology and Reproductive Sciences of the University of Pittsburgh, Magee-Womens Hospital of the University of Pittsburgh Medical Center, 300 Halket Street, Suite 2323, Pittsburgh, PA, USA. cartercm4@upmc.edu.
International Urogynecology Journal
|March 31, 2018
Summary
Performing a day-of-surgery voiding trial for pelvic organ prolapse surgery may reduce the time to spontaneous voiding. This early trial did not prolong catheter use and facilitated earlier ambulation in women undergoing reconstructive surgery.
Area of Science:
- Urogynecology
- Pelvic Floor Reconstructive Surgery
Background:
- Post-operative urinary retention is a concern in women undergoing pelvic organ prolapse surgery.
- The impact of early, day-of-surgery voiding trials on recovery is not well-established.
Purpose of the Study:
- To evaluate if a day-of-surgery voiding trial shortens the time to spontaneous voiding compared to a post-operative day 1 trial.
- To assess the effect of early voiding trials on catheter use and patient ambulation.
Main Methods:
- A randomized, parallel-arm trial compared early (4 hours post-op) versus standard (post-op day 1) retrograde voiding trials.
- 57 women undergoing major pelvic floor reconstructive surgery were randomized 1:1.
Main Results:
- While the intention-to-treat analysis showed no significant difference (p=0.081), adjusted and per-protocol analyses indicated an earlier spontaneous void with early trials (p=0.022).
- Early voiding trial patients ambulated sooner and more frequently (p=0.02).
- No prolonged catheter use was observed.
Conclusions:
- A day-of-surgery voiding trial is a safe option after pelvic organ prolapse surgery.
- Early voiding trials may expedite recovery by reducing time to spontaneous voiding and improving ambulation.
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