A novel approach to postoperative bladder care in women after radical hysterectomy.
OBJECTIVE
Currently, controversy exists with regard to the duration of bladder drainage and choice of catheter used in women who undergo radical hysterectomy. In this manuscript, we propose a novel approach to improving postoperative bladder care in women who undergo radical hysterectomy.


METHODS
This is a retrospective study of women who underwent Type 3 Piver radical hysterectomy in a gynaecological oncology centre in the United Kingdom from January 2009 to September 2011. We report the outcomes of removal of urinary catheter 48-72 h following radical hysterectomy.


RESULTS
Over a 32-month period, 30 women underwent radical hysterectomy. 19 (63.3 %) women underwent surgery for treatment of cervical cancer, 5 (16.7 %) women for management of endometrial cancer, 6 (20 %) women for other conditions. One patient underwent partial cystectomy at the time of radical hysterectomy and was not included in the analysis. Of the 29 patients, only five (17.2 %) were found to have urinary residuals greater than 100 ml following the removal of the indwelling catheter on the second postoperative day and required recatheterisation. 82.8 % of the patients had the catheter removed within 48-72 h postoperatively. None of these patients required re-admission with urinary retention.


CONCLUSIONS
Removal of urinary catheter on the second postoperative day following radical hysterectomy is feasible and not associated with increased morbidity. This approach may be particularly useful to complement the introduction of laparoscopic and robotic surgical approaches for surgical management of cervical cancer.
Department of Obstetrics and Gynaecology, Norfolk and Norwich University Hospital NHS Foundation Trust, Colney Lane, Norwich, NR4 7UY, UK. hilaryturnbull1@gmail.com
Hilary
H
Turnbull
Nikolaos
N
Burbos
Mazen
M
Abu-Freij
Timothy J
TJ
Duncan
Joaquin J
JJ
Nieto
D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D011182:Postoperative Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013997:Time Factors; D014546:Urinary Catheterization / Q000706:statistics & numerical data*