A nationwide survey to measure practice variation of catheterisation management in patients undergoing vaginal prolapse surgery.
OBJECTIVE
Urinary catheterisation following vaginal prolapse surgery causes inconvenience for patients, risk of urinary tract infections and potentially longer hospitalisation. Possibly, practice variation exists concerning diagnosis and management of abnormal postvoid residual (PVR) volume implying suboptimal treatment for certain subgroups.


METHODS
Nationwide questionnaire-based survey.


RESULTS
Post-operatively, 77% performed transurethral indwelling catheterisation, 12% suprapubic catheterisation and 11% intermittent catheterisation. Catheterisation was applied 3 days (1-7 days) following anterior repair and 1 day (1-3 days) following all other procedures. The median cut-off point for abnormal PVR was 150 mL (range 50-250 mL). Treatment of abnormal PVR consisted mostly of prolonging transurethral indwelling catheterisation for 2 days (range 1-5 days; 57%), 29% by intermittent and 12% by suprapubic catheterisation. Antibiotics were administered by 21% either routinely or based on symptoms only.


CONCLUSIONS
Due to insufficient evidence and suboptimal implementation of available evidence, practice variation in catheterisation regimens is high.
Hakvoort
R A
RA
Department of Obstetrics and Gynaecology, Spaarne Hospital, P.O. Box 770, 2130 AT, Hoofddorp, The Netherlands. rhakvoort@spaarneziekenhuis.nl
Burger
M P
MP
Emanuel
M H
MH
Roovers
J P
JP
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D055499:Catheter-Related Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D009426:Netherlands; D017060:Patient Satisfaction; D010818:Practice Patterns, Physicians'; D012307:Risk Factors; D014546:Urinary Catheterization / Q000295:instrumentation / Q000706:statistics & numerical data*; D014596:Uterine Prolapse / Q000601:surgery*
D000900:Anti-Bacterial Agents