Postoperative voiding, bacteriuria and urinary tract infection with Foley catheterization after gynecological surgery.
BACKGROUND
The use of bladder drainage to avoid urinary retention after gynecological surgery is more or less custom based, and duration of drainage varies considerably. In this paper the use of 1-day drainage by transurethral Foley catheter was investigated with regard to impaired voiding, asymptomatic bacteriuria, and urinary tract infection. Furthermore, the use of methenamine hippurate was studied with regard to postoperative asymptomatic bacteriuria and urinary tract infection. METHODS. This summary is based on six published papers totaling 917 patients. In three case series, 1-day catheterization was used in women undergoing gynecological laparotomy, colposuspension, or vaginal plastic surgery. To compare 1- and 3-day Foley catheterization, two open, randomized trials were performed on women undergoing vaginal plastic surgery or colposuspension. The last study was a double-blind trial between methenamine hippurate and placebo as prophylaxis against urinary tract infection and asymptomatic bacteriuria using 1-day catheterization.


RESULTS
Postoperative voiding problems and urinary tract infection occurred infrequently with 1-day catheterization, and no more frequently than with catheterization for three days. Methenamine hippurate decreased the incidence of urinary tract infection and asymptomatic bacteriuria by 80 and 40%, respectively.


CONCLUSIONS
One-day bladder drainage by transurethral Foley catheter may be used routinely in common gynecological surgery with a low rate of voiding problems, asymptomatic bacteriuria, and urinary tract infection. Methenamine hippurate prophylaxis effectively reduces postoperative urinary tract infection.
Schiøtz
Hjalmar A
HA
Department of Obstetrics and Gynecology, Vestfold Hospital, Norway. hjalmar.schiotz@siv.no
Tanbo
Tom G
TG
D000892:Anti-Infective Agents, Urinary / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification; D002986:Clinical Trials as Topic; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006626:Hippurates / Q000627:therapeutic use; D006801:Humans; D008709:Methenamine / Q000031:analogs & derivatives / Q000627:therapeutic use; D011183:Postoperative Complications; D011446:Prospective Studies; D013997:Time Factors; D016482:Urinalysis; D014546:Urinary Catheterization / Q000009:adverse effects*; D016055:Urinary Retention / Q000517:prevention & control; D014552:Urinary Tract Infections / Q000209:etiology*; D014554:Urination
D000892:Anti-Infective Agents, Urinary; D006626:Hippurates; D008709:Methenamine; C011481:methenamine hippurate