Comparison of Urinary Tract Infection Rates Associated with Different Catheterization Methods Following Major Pelvic...

Area of Science:

• Urology
• Infectious Disease
• Surgical Outcomes

Background:

• Postoperative bladder drainage is essential after major pelvic or abdominal surgery.
• Urinary tract infection (UTI) risk varies significantly with different catheterization methods.
• Comparative effectiveness of indwelling Foley catheterization (IFC), suprapubic catheterization (SPC), and intermittent catheterization (IC) for UTI prevention is unclear.

Purpose of the Study:

• To compare the incidence of UTI associated with IFC, SPC, and IC.
• To evaluate the comparative effectiveness of different urinary drainage methods in reducing postoperative UTI risk.

Main Methods:

• Bayesian network meta-analysis of 10 randomized controlled trials (RCTs) involving 1242 patients.
• Searched PubMed and Cochrane Library for RCTs published between January 2010 and November 2025.
• Assessed UTI rates as the primary outcome and used the GRADE approach for evidence quality.

Main Results:

• Both intermittent catheterization (IC) and suprapubic catheterization (SPC) showed a reduced risk of UTI compared to indwelling Foley catheterization (IFC).
• SPC did not show a statistically significant reduction in UTI compared to IC, with considerable uncertainty.
• IC and SPC demonstrated favorable trends in reducing overall catheter-related complications versus IFC.

Conclusions:

• SPC and IC appear more effective than IFC in lowering postoperative UTI risk.
• Further high-quality RCTs integrating urinary drainage with bladder rehabilitation are necessary.
• Optimal management strategies for postoperative bladder drainage require further investigation.