Efficiency of using a Foley catheter as a pelvic drain in vaginal hysterectomy

Abstract

Objectives: Vaginal hysterectomy can be associated with a significant risk of vault haematomas with consequent postoperative morbidity. The aim of this study was to assess the use of a Foley Catheter as a vaginal drain in premenopausal women undergoing a vaginal hysterectomy and the impact on different outcomes including development of vault haematoma, length of hospital stay, antibiotics usage, readmissions to the hospital and febrile morbidity in the immediate postoperative period.

Study design: This study was conducted at a tertiary teaching hospital and was a retrospective cohort study of women undergoing a vaginal hysterectomy. The study compared 52 women in the study group with a Foley catheter drain to 51 age matched controls without a drain who underwent surgery for similar indications. Outcomes were compared using the Chi square test and student t-test.

Results: Comparing women with a drain to those without demonstrated a statistically significant difference with worse outcomes for all parameters in women without a drain: evidence of vault haematomas (0 vs 8; p = 0.0025); length of hospital stay over 2 days (3 vs 15; p = 0.001); discharge with antibiotics for vault haematomas (5 vs 0; p = 0.028) and readmission rates (0 vs 7; p = 0.005). There was no statistical difference in the number of women with temperatures over 38 °C (4 vs 2; p = 0.3) in either group.

Conclusion: A Foley catheter used as a pelvic drain following a vaginal hysterectomy reduces postoperative complications associated with vault haematomas with shorter hospital stay, lower antibiotic usage and lower readmission rate.

Keywords: Drain; Vaginal hysterectomy; Vault haematoma.