title: Timing of urinary catheter removal after uncomplicated total abdominal hysterectomy: a prospective randomized trial.
abstract: OBJECTIVE
  To assess whether immediate (0h), intermediate (after 6h) or delayed (after 24h) removal of an indwelling urinary catheter after uncomplicated abdominal hysterectomy can affect the rate of re-catheterization due to urinary retention, rate of urinary tract infection, ambulation time and length of hospital stay.
  
  
  METHODS
  Prospective randomized controlled trial conducted at Suez Canal University Hospital, Egypt. Two hundred and twenty-one women underwent total abdominal hysterectomy for benign gynecological diseases and were randomly allocated into three groups. Women in group A (73 patients) had their urinary catheter removed immediately after surgery. Group B (81 patients) had the catheter removed 6h post-operatively while in group C (67 patients) the catheter was removed after 24h. The main outcome measures were the frequency of urinary retention, urinary tract infections, ambulation time and length of hospital stay.
  
  
  RESULTS
  There was a significantly higher number of urinary retention episodes requiring re-catheterization in the immediate removal group compared to the intermediate and delayed removal groups (16.4% versus 2.5% and 0% respectively). Delayed urinary catheter removal was associated with a higher incidence of urinary tract infections (15%), delayed ambulation time (10.3h) and longer hospital stay (5.6 days) compared to the early (1.4%, 4.1h and 3.2 days respectively) and intermediate (3.7%, 6.8h and 3.4 days respectively) removal groups.
  
  
  CONCLUSIONS
  Removal of the urinary catheter 6h postoperatively appears to be more advantageous than early or late removal in cases of uncomplicated total abdominal hysterectomy.
authors.affiliation: Department of Obstetrics and Gynecology, Suez Canal University, Egypt. Electronic address: dr_magdygyn@yahoo.com.
authors.forename: Magdy R
authors.initials: MR
authors.lastname: Ahmed
authors.affiliation: Department of Obstetrics and Gynecology, Suez Canal University, Egypt.
authors.forename: Waleed A
authors.initials: WA
authors.lastname: Sayed Ahmed
authors.affiliation: Department of Obstetrics and Gynecology, Suez Canal University, Egypt.
authors.forename: Khaled A
authors.initials: KA
authors.lastname: Atwa
authors.affiliation: Department of Microbiology and Immunology, Suez Canal University, Egypt.
authors.forename: Lobna
authors.initials: L
authors.lastname: Metwally
mesh_terms: D020878:Device Removal; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D011446:Prospective Studies; D062885:Urinary Catheters / Q000009:adverse effects*; D016055:Urinary Retention / Q000209:etiology*; D014552:Urinary Tract Infections / Q000209:etiology* / Q000517:prevention & control; D016138:Walking
keywords: Catheter-associated urinary retention; In-dwelling urinary catheter; Total abdominal hysterectomy; Urinary tract infections