Bladder drainage: a survey of practices among gynaecologists in the British Isles

All 2836 members and fellows of the Royal College of Obstetricians and Gynaecologists were circulated with a questionnaire concerning catheterization practices; 1229 replies were received, an overall response rate of 43%; the response rate from practitioners of consultant and senior registrar status was 67%. Practices varied considerably, some aspects of management apparently relating to the age or experience of the surgeon, some to their level of interest or surgical commitment in gynaecological urology, and some showing regional variation. Of the 960 respondents in active gynaecological practice, 84-93% (depending on the operation) drained the bladder before routine abdominal procedures, 52-54% (depending on the route) drained the bladder before incontinence surgery, and 62-70% routinely used continuous bladder drainage for periods between 1 and 12 days following these procedures. Overall, 51% of respondents preferred urethral, and 39% suprapubic catheters for postoperative bladder drainage; this showed a marked regional- and experience-related variation. Prophylactic antibiotics were used by 32% of gynaecologists overall, and a wide variety of other measures were employed in the management of catheter-associated infection, and other problems of catheter management.