Removal of indwelling urinary catheter in prolapse surgery patients

Abstract

Introduction: Postoperative urinary retention is an important complication in prolapse surgery patients. However, there is no consensus regarding the optimal timing for postoperative urinary catheter removal. To provide effective and evidence-based healthcare, we will compare same-day midnight removal with IUC removal the morning after surgery. Methods: In this retrospective cohort study, 654 patients who underwent prolapse surgery between January 2020 and September 2023 were included. In the early removal group (n= 309), the IUC was removed at midnight on the day of the surgery, in the late removal group (n= 293), it was removed the following morning. Also, information regarding the risk factors for POUR, discharge time and results of the PGI-I questionnaire was retrieved and analyzed. Results: No differences regarding the risk of POUR was found between the early and late removal groups (OR 1.05 (95% CI: 0.68, 1.60)). An increased CCI score, stage III and IV prolapse, longer surgery time, spinal anesthesia and pain are considered as independent risk factors for POUR, a higher BMI reduces the risk of POUR. patients diagnosed and treated for urinary retention had a significant higher chance on an urinary tract infection during recovery. Patients within the early removal groups were discharged approximately nine hours earlier. Conclusions: Midnight removal of the IUC after prolapse surgery does not lead to an increased risk of POUR and is therefore considered as a safe alternative for catheter removal the following morning. In addition, this may contribute to more effective healthcare and optimization of hospital capacity.