title: Are in-dwelling catheters necessary for 24 hours after hysterectomy?
abstract: OBJECTIVE
  In-dwelling catheters for 24 hours after operation are used routinely in gynecologic surgery. This study assesses whether the immediate removal of an in-dwelling catheter after the operation affects the rate of recatheterization, febrile morbidity, symptomatic urinary tract infections, or subjective pain assessments.
  
  
  METHODS
  This study was a prospective randomized controlled trial comprised of 250 women who underwent hysterectomy and who did not require bladder suspension or strict fluid treatment. The in-dwelling catheter was removed either immediately after the operation or on the first day after the operation. The association between clinical variables and the length of catheterization were assessed by chi-squared analysis.
  
  
  RESULTS
  Patients were assigned randomly into 2 groups, with no significant differences in the outcomes, only in the perception of pain. Clinical events included fever (>/=38.5 degrees C) that occurred in 6 patients in the in-dwelling catheter group compared with 5 patients in the early removal group (P=.01), symptomatic urinary tract infections in 3 patients in both groups (P=.99), and recatheterization in 3 patients in the in-dwelling catheter group compared with 5 patients in the early removal group (P=.17). Subjectively, patients in the early removal group reported significantly less pain than did the in-dwelling group (P<.001).
  
  
  CONCLUSIONS
  The early removal of in-dwelling catheters after operation was not associated with an increased rate of febrile events, urinary tract infections, or need for recatheterization. In addition, subjective pain assessment was significantly less in the early removal group. Early removal of an in-dwelling catheter immediately after operation is not associated with adverse events.
authors.affiliation: University of Colorado Health Science Center, Denver Health Medical Center, Colorado 80204, USA. tdunn@dhha.org
authors.forename: Terry S
authors.initials: TS
authors.lastname: Dunn
authors.forename: Judith
authors.initials: J
authors.lastname: Shlay
authors.forename: Dave
authors.initials: D
authors.lastname: Forshner
mesh_terms: D000328:Adult; D000368:Aged; D002408:Catheters, Indwelling / Q000009:adverse effects; D020878:Device Removal / Q000009:adverse effects; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D011182:Postoperative Care / Q000009:adverse effects; D013997:Time Factors