Postoperative Indwelling Catheter Management in Vaginal Prolapse Surgery

Pelvic organ prolapse surgery with a vaginal approach is generally performed with an indwelling catheter and in a day care unit. There is no international consensus regarding removal time of catheter after surgery. We hypothesized that reducing the length of postoperative catheterization from 2 hours to 0 would not compromise the logistic and clinical feasibility of the day care unit for prolapse surgery. Second, we hypothesized that this change would not lead to an increase in adverse postoperative events.

A historical cohort quality study comparing immediate removal of the indwelling catheter (group 1, n = 182) with removal 2 hours postoperatively (group 2, n = 209) after pelvic organ prolapse surgery. Demographic data, type of surgery, referral to the stationary unit, complications, and contact after discharge were recorded. Follow-up time was 3 months. Statistics included Kruskal-Wallis and χ² tests.

Demographic data and type of surgery were comparable. Referrals to the stationary unit were infrequent in both groups and too limited to allow statistical comparison. However, no negative impact on the feasibility of the day care unit was detected. No change in adverse events was found. Postoperative contact with the hospital increased after the change with 19.3% in group 1 and 11.0% in group 2 (P = 0.02). The indications for contact were the same.

The reduction in catheter removal time did not affect the feasibility of the day care unit. However, a subsequent increase in postoperative contacts was observed, which is likely to reflect concurrent structural changes within the department.