A prospective, randomized trial comparing continuous bladder drainage with catheterization at abdominal hysterectomy.
OBJECTIVE
To compare the infection rate and post-operative morbidity between in-dwelling urinary catheterization and 'in-out' catheterization at the time of routine total abdominal hysterectomy.


METHODS
The study comprised 100 patients who were blindly randomized to have either an indwelling Foley catheter or an 'in-out' catheterization at the time of surgery. Follow-up data on the retention of urine, urinary symptoms and infection were obtained.


RESULTS
Of the 95 patients with complete data, 36% of those undergoing in-out catheterization had urinary retention after operation, requiring bladder emptying, compared with 4% of those receiving an indwelling catheter (P < 0.001). In addition, 29% of the catheterized group had urinary tract bacteriuria compared with 13% of the uncatheterized group (P < 0.025).


CONCLUSIONS
This randomized controlled trial showed that in-out urinary catheterization at the time of routine abdominal hysterectomy was associated with a significantly higher incidence of post-operative urinary retention compared with in-dwelling catheterization, and may have implications for long-term bladder function.
Dobbs
S P
SP
Department of Obstetrics and Gynaecology, Queen's Medical Centre, Nottingham, UK.
Jackson
S R
SR
Wilson
A M
AM
Maplethorpe
R P
RP
Hammond
R H
RH
D000328:Adult; D001437:Bacteriuria / Q000209:etiology; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D014546:Urinary Catheterization / Q000009:adverse effects* / Q000379:methods; D016055:Urinary Retention / Q000209:etiology*; D014552:Urinary Tract Infections / Q000209:etiology*