A prospective, randomised, controlled trial comparing 3 hour and 24 hour postoperative removal of bladder catheter and vaginal pack following vaginal prolapse surgery.
BACKGROUND
The aim of this prospective, randomised, study was to determine whether or not there was a higher incidence of bleeding, reoperation, urinary retention or bacterial count in the urine, depending on whether urinary catheter and vaginal pack was removed 3 h or 24 h after vaginal prolapse surgery.


METHODS
Some 136 women were randomised into Group 1 (removal of catheter and vaginal pack after 3 h), and Group 2 (removal of catheter and vaginal pack after 24 h). Data on postoperative bleeding, reoperation, and urinary retention were collected. Preoperatively, day after operation, and 14 days after operation, a urine culture was performed.


RESULTS
There was no tendency towards more bleeding with early removal of vaginal pack and urinary catheter. No patients in either group were reoperated during the first 48 postoperative hours. Three patients in Group 1 required sterile intermittent catheterisation postoperatively, however, only once in 2 patients. There was a trend towards a higher postoperative bacterial count in patients in Group 2 (p=0.306).


CONCLUSIONS
We recommend removing the vaginal pack and urinary catheter after 3 h with careful monitoring of the patient's voiding.
Glavind
Karin
K
Department of Gynecology and Obstetrics, Aalborg Sygehus, Aalborg, Denmark. glavind@dadlnet.dk
Mørup
Lisbeth
L
Madsen
Hans
H
Glavind
Julie
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015169:Colony Count, Microbial; D005260:Female; D006801:Humans; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000453:epidemiology*; D011446:Prospective Studies; D012086:Reoperation / Q000706:statistics & numerical data; D013997:Time Factors; D014546:Urinary Catheterization / Q000009:adverse effects; D016055:Urinary Retention / Q000453:epidemiology*; D014552:Urinary Tract Infections / Q000453:epidemiology*; D014556:Urine / Q000382:microbiology; D014596:Uterine Prolapse / Q000601:surgery*