title: Suprapubic or urethral catheter: what is the optimal method of bladder drainage after radical hysterectomy?
abstract: BACKGROUND
  Lower urinary tract dysfunction is a common morbidity related to radical hysterectomy (RAH). Although transurethral catheterization (TUC) has traditionally been used for postoperative bladder drainage following RAH, suprapubic catheterization (SPC) is an alternative method that may be advantageous.
  
  
  OBJECTIVE
  To determine, by means of a retrospective cohort study, the incidence of urinary tract infection (UTI), duration of postoperative hospital stay, and time to trial of voiding in women catheterized suprapubically or transurethrally after RAH for early stage cervical cancer.
  
  
  METHODS
  Two hundred twelve patients who underwent RAH and staging for stage IA1 + LVS, 1A2, and 1B1 cancer of the cervix in Edmonton between 1996 and 2006 were included in the study. Three gynaecologic oncologists performed the surgeries. Operative, postoperative, and demographic data were extracted from patient records. Patients were catheterized either suprapubically (SPC group) or transurethrally (TUC group) according to the surgeon's discretion. Comparative tests and multivariate regression analysis were used to compare outcome measures between the groups and to adjust for confounding variables.
  
  
  RESULTS
  The TUC group had a higher proportion of patients with UTI (27%) than the SPC group (6%) (P < 0.001). The SPC group had a shorter postoperative hospital stay (4.8 vs. 5.7 days; P < 0.001) and an earlier trial of voiding (2.7 vs. 4.4 days; P < 0. 001). Following regression analysis, statistically significant differences remained for UTI and time to initiation of a trial of voiding.
  
  
  CONCLUSIONS
  After RAH for early stage cervical cancer, suprapubic catheterization is associated with a lower rate of UTI and an earlier trial of voiding than transurethral catheterization.
authors.affiliation: University of Alberta, Department of Obstetrics and Gynecology, Edmonton AB.
authors.forename: Tiffany H
authors.initials: TH
authors.lastname: Wells
authors.affiliation: University of Alberta, Department of Obstetrics and Gynecology, Edmonton AB; Department of Gynecologic Oncology, Cross Cancer Institute, Edmonton AB.
authors.forename: Helen
authors.initials: H
authors.lastname: Steed
authors.affiliation: University of Alberta, Department of Obstetrics and Gynecology, Edmonton AB; Department of Gynecologic Oncology, Cross Cancer Institute, Edmonton AB.
authors.forename: Valerie
authors.initials: V
authors.lastname: Capstick
authors.affiliation: University of Alberta, Department of Obstetrics and Gynecology, Edmonton AB; Department of Gynecologic Oncology, Cross Cancer Institute, Edmonton AB.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Schepanksy
authors.affiliation: University of Alberta, Department of Obstetrics and Gynecology, Edmonton AB.
authors.forename: Michelle
authors.initials: M
authors.lastname: Hiltz
authors.affiliation: University of Alberta, Department of Obstetrics and Gynecology, Edmonton AB; Department of Gynecologic Oncology, Cross Cancer Institute, Edmonton AB.
authors.forename: Wylam
authors.initials: W
authors.lastname: Faught
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004322:Drainage; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007902:Length of Stay; D008875:Middle Aged; D011182:Postoperative Care; D012189:Retrospective Studies; D001743:Urinary Bladder; D014546:Urinary Catheterization / Q000009:adverse effects / Q000379:methods*; D014552:Urinary Tract Infections / Q000453:epidemiology; D014554:Urination; D055815:Young Adult