A randomized controlled trial comparing short versus long-term catheterization after uncomplicated vaginal prolapse surgery

Abstract

Aims: Routine catheterization following vaginal prolapse surgery has advantages like prevention of postoperative retention of urine and prevention of any adverse effect on surgical outcome. However, it increases the risk of urinary tract infection (UTI), prevent early ambulation and prolong hospital stay. This randomized controlled trial was done on how best to minimize catheter related complication after prolapse surgery.

Methods: 200 patients planned for vaginal prolapse surgery were recruited and randomized into two groups. In group I and group II catheter was removed on 1(st) and 4(th) post operative day, respectively. After removal, if patient could not void or when residual urine volume exceeds 150 mL, recatheterisation was done for another three days. Sample of urine was sent for culture during catheter removal.

Results: Age, parity, type of surgery and mean operation time did not differ significantly between the two groups. Mean duration of catheterization was significantly shorter (1.64 vs 4.09) and mean duration of hospital stay was shorter by 1.2 days, in first group. However a significantly higher number of retention of urine or residual urine more than 150 mL was found in the early removal group (OR 3.10) but lesser chance of development of urinary tract infection (OR 0.10).

Conclusions: The early removal of catheter seems more advantageous, with lower incidence of urinary tract infection and a shorter hospital stay although associated with an increased risk of recatheterisation.