Parental home removal of urethral catheters after urological surgery-a prospective benchmarking study
1Department of Paediatric Surgery and Urology, Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
Insights
Parents can safely remove urethral Foley catheters at home by cutting the balloon port. This method is effective, reduces patient stress, and saves healthcare costs.
Area of Science:
- Urology
- Pediatric Surgery
- Healthcare Management
Background:
- Urological operations frequently necessitate urethral Foley catheter placement.
- Post-discharge catheter removal often requires hospital admission or nurse visits.
- Current practices present logistical and patient comfort challenges.
Purpose of the Study:
- To evaluate the safety and success rate of parental home removal of urethral Foley catheters in pediatric patients.
- To assess the feasibility of parents removing catheters by cutting the balloon port valve.
- To compare home removal with traditional professional catheter removal methods.
Main Methods:
- A prospective study was conducted in a pediatric urology center over 12 months.
- Included patients were under 16 years old, typically post-hypospadias repair or penile surgery.
- Parents received verbal and written instructions; telephone follow-up assessed outcomes.
Main Results:
- 38 pediatric patients participated; 92% of home removals were successful.
- The median time for catheter passage was 3 hours (range 0-24 hours).
- This method resulted in estimated NHS cost savings of £4550 over the study period.
Conclusions:
- Parental home catheter removal is a safe and feasible alternative to professional removal.
- The technique offers benefits including improved patient experience, minimal trauma, and significant cost savings.
- Positive parental feedback indicates high satisfaction with the home removal process.
Introduction:
Many urological operations require placement of a urethral Foley catheter. The catheter often needs to remain in situ for a period of time after discharge; and patients subsequently require either a further hospital admission or community nurse review for catheter removal. Parents can easily remove the catheter at home by cutting the balloon port. This disrupts the valve and hence deflates the retaining balloon, thereby facilitating spontaneous passage of the catheter. The authors introduced this practice to their institution.
Aim:
The aim was to assess safety and success of parental home catheter removal.
Methods:
A prospective data study was performed in a large pediatric urology center over a 12-month time period. Patients <16 years after single-stage hypospadias repair or other penile surgery were included on a voluntary basis. Parents of eligible patients were instructed verbally and with an information leaflet, including date for removal. Telephone follow-up after removal was undertaken to assess the outcome.
Results:
Thirty-eight patients were included over a 12-month time period. Patient age ranged from 9 months to 12 years (median age 2.5 years). The majority (82%) of patients had required a catheter after hypospadias repair. Home catheter removal was successful in 92% cases. Three children required professional support for catheter removal. Median time until catheter passage was 3 h (range 0-24 h). Considering that cost for day case admission for catheter removal averages at 130£ per patient, home catheter removal saved the NHS 4550£ in the time period.
Discussion:
This is the first study to report the safety and feasibility of parental home catheter removal by cutting the balloon port valve in the pediatric population. It offers a number of distinct advantages compared with traditional methods for removal. These include, namely, (i) positive patient experience: catheter removal in a familiar environment by a relative minimizes stressful experiences for the family; (ii) minimal trauma to healing tissues through spontaneous catheter passage; and (iii) health care-related cost savings. This was an initial benchmarking study, so patient numbers were relatively small. Nevertheless, it shows that the method is safe and received positive parental feedback.
Conclusion:
Parental home removal of a urethral catheter is a feasible and safe alternative to catheter removal by a health-care professional. It minimizes parental anxiety and inconvenience related to the catheter removal appointment and allows for significant cost savings.
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