Home Removal of Urinary Catheters After Pelvic Floor Reconstruction Surgery

This study is aimed at comparing home with hospital removal of urinary catheters after surgical correction of pelvic floor disorders.

This is a retrospective cohort study at a single urogynecology practice (1 May 2020 to 30 November 2024). A total of 184 patients, age 33-86 years (mean 66.2) with a diagnosis of pelvic floor disorder underwent home removal (primary n = 31, secondary n = 34) or hospital removal (n = 153) of a urinary catheter after pelvic floor reconstructive surgery (IRB Pro2024-0473).

The incidence of urinary retention was significantly lower in the primary home-removal group (3.3% ± 3.3%, n = 1, 95% CI 0-9.8%) compared with the hospital-removal group (27.5% ± 3.6%, n = 42, 95% CI 20.3-34.6%; p = 0.004). Of those with urinary retention, most underwent home removal for a secondary void trial (n = 34, 81.0%). The incidence of catheter-associated urinary tract infections (CAUTIs) was increased but not statistically significantly in the primary home-removal group (22.6% ± 7.6%, 95% CI 7.0-38.2%) compared with the hospital-removal group (9.2% ± 2.3%, 95% CI 4.5-13.8%; p = 0.056). The duration of the primary hospital admission was significantly shorter for the home removal of urinary catheterization (0.3 ± 0.1 day vs 1.1 ± 0.1 day; p < 0.0001). There was no significant difference in readmission (p = 0.593) or return to the operating room (p > 0.999).

Home catheter removal after pelvic floor reconstructive surgery appears feasible in selected patients and is associated with reduced hospital utilization and lower urinary retention rates. However, a trend toward increased CAUTIs cannot be dismissed. Therefore, prospective randomized trials are needed to definitively establish safety and identify appropriate patient selection criteria before widespread adoption.