A prospective, randomized trial comparing immediate versus delayed catheter removal following hysterectomy.
BACKGROUND
A prospective, randomized study was used to assess whether the immediate removal of an in-dwelling catheter after hysterectomy affects the rate of recatheterization, symptomatic urinary tract infections, time of ambulation, and hospital stay.


METHODS
We randomly assigned 96 women who underwent hysterectomy [44 vaginal hysterectomy (VH), 37 abdominal hysterectomy, and 15 laparoscopic assisted VH) to three groups. The in-dwelling catheter was removed immediately (group A), at 6 hr (group B), or at 12 hr (group C) after the operation. The association between clinical variables and the length of catheterization was assessed by Chi-square analysis.


RESULTS
Recatheterization occurred in six patients (18.8%) of group A, all after VH under spinal anesthesia. All patients in the groups B and C could spontaneously void the bladder after catheter removal. Symptomatic urinary tract infection occurred in one patient in group A, compared with four patients in group B, and five in group C. The mean time to ambulation was 4.3 hr in group A, 6.5 hr in group B, and 9.4 hr in group C. Patients with immediate removal of urinary catheter had a shorter hospital stay.


CONCLUSIONS
There could be an association between necessity of recatheterization and the type of surgery (VH) or the type of anesthesia (spinal). Despite recatheterization rate, early removal of in-dwelling catheters immediately after uncomplicated hysterectomy seems to decrease first ambulation time and hospital stay.
Alessandri
Franco
F
Department of Obstetrics and Gynecology, Genova University, Italy.
Mistrangelo
Emanuela
E
Lijoi
Davide
D
Ferrero
Simone
S
Ragni
Nicola
N
D000328:Adult; D000368:Aged; D002408:Catheters, Indwelling / Q000009:adverse effects*; D016009:Chi-Square Distribution; D020878:Device Removal / Q000009:adverse effects; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D011182:Postoperative Care / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D013997:Time Factors; D014546:Urinary Catheterization; D014552:Urinary Tract Infections / Q000517:prevention & control*