title: A prospective randomised controlled trial of intermittent self-catheterisation vs. supra-pubic catheterisation for post-operative bladder care following radical hysterectomy.
abstract: OBJECTIVE
  To determine the potential benefits of ISC (intermittent self-catheterisation) over SPC (supra-pubic catheterisation) in the post-operative bladder care of women following radical hysterectomy.
  
  
  METHODS
  A prospective randomised controlled trial of women treated by radical hysterectomy for early stage cervical cancer. RESULTS.: 40 women were recruited to the study, 21 to ISC and 19 to SPC. All patients randomised to ISC were able to learn the technique of ISC satisfactorily following a period of pre-operative training. The day 3 and day 5 positive CSU (catheter specimen of urine) rate was significantly higher in the ISC group (42% and 63%) compared to the SPC group (6% and 18%), P = 0.05 and P = 0.004, respectively). Eight of 17 patients randomised to SPC (47%) documented having symptoms/problems arising from the SPC site of which 4 (23%) were shown to have a positive wound swab. There was no significant difference in length of period for bladder care between the two groups, P = 0.83. However, there were significant differences in patient acceptability (P = 0.009), freedom to lead a normal life (P = 0.000), disturbance at night (P = 0.006) and patient anxiety/embarrassment (P = 0.005) between the two groups.
  
  
  CONCLUSIONS
  Patients are able to learn the technique of ISC without difficulty. Despite a greater urinary tract infection rate, the high incidence of SPC site problems can be avoided by use of ISC. The technique of ISC was seen to be more acceptable to patients allowing fewer disturbances at night, greater freedom to lead a normal life during the day and less anxiety/embarrassment compared to SPC.
authors.affiliation: Northern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Sheriff Hill, Gateshead, Tyne and Wear NE9 6SX, UK. raj@naik313.fsnet.co.uk
authors.forename: R
authors.initials: R
authors.lastname: Naik
authors.forename: K
authors.initials: K
authors.lastname: Maughan
authors.forename: A
authors.initials: A
authors.lastname: Nordin
authors.forename: A
authors.initials: A
authors.lastname: Lopes
authors.forename: K A
authors.initials: KA
authors.lastname: Godfrey
authors.forename: M H
authors.initials: MH
authors.lastname: Hatem
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D011446:Prospective Studies; D012648:Self Care / Q000379:methods*; D011795:Surveys and Questionnaires; D014546:Urinary Catheterization / Q000379:methods*; D014555:Urination Disorders / Q000209:etiology / Q000628:therapy*; D002583:Uterine Cervical Neoplasms / Q000601:surgery*