title: A meta-analysis comparing suprapubic and transurethral catheterization for bladder drainage after abdominal surgery.
abstract: BACKGROUND
  Although bladder drainage is widely used for general surgical patients undergoing laparotomy, there is little consensus on whether suprapubic or transurethral catheterization is better.
  
  
  METHODS
  A systematic database search was undertaken to find all studies of suprapubic catheterization. Randomized controlled trials were identified for inclusion. Endpoints for analysis were bacteriuria, patient satisfaction and recatheterization rates. A meta-analysis was performed using fixed-effect or random-effect models as appropriate, depending on heterogeneity.
  
  
  RESULTS
  After abdominal surgery, transurethral catheterization is associated with significant bacteriuria (relative risk (RR)=2.02, P<0.001, 95 percent confidence interval (c.i.) 1.34 to 3.04) and pain or discomfort (RR=2.94, P=0.004, 95 percent c.i. 1.41 to 6.14). Recatheterization rates using the transurethral method were not increased significantly (RR=1.97, P=0.213, 95 percent c.i. 0.68 to 5.74) with heterogeneity between studies.
  
  
  CONCLUSIONS
  The suprapubic route for bladder drainage in general surgery is more acceptable to patients and reduces microbiological morbidity.
authors.affiliation: University Surgical Unit, Mail Point 816, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
authors.forename: M J W
authors.initials: MJ
authors.lastname: McPhail
authors.forename: M
authors.initials: M
authors.lastname: Abu-Hilal
authors.forename: C D
authors.initials: CD
authors.lastname: Johnson
mesh_terms: D000005:Abdomen / Q000601:surgery*; D001437:Bacteriuria / Q000517:prevention & control; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D001743:Urinary Bladder; D014546:Urinary Catheterization / Q000379:methods*; D016055:Urinary Retention / Q000517:prevention & control