The Urethral Catheter Can Be Removed Safely Three Days after Kidney Transplantation Instead of Five Days

Abstract

Background: Kidney transplantation is currently the optimal treatment for end-stage kidney disease. Although many parts of the surgery have been researched and standardized, the optimal duration of urethral catheterization is still unknown. Urethral catheters are usually left in place between 4-10 days. It is thought that urethral catheterization decreases the incidence of urological complication, such as urine leakage, by decreasing pressure on the new cystoureteric anastomosis. However, prolonged urethral catheterization might also increase the risk of urinary tract infections. The currently available studies indicate that it could be optimal to remove the urethral catheter earlier than 4-10 days. This appears to lower the risk of UTI, while not negatively affecting the incidence of important urological complications, such as urine leakage. Methods: This analysis was a single centre non-randomized retrospective analysis comparing urethral catheter removal at three days after kidney transplantation to removal at five days after kidney transplantation. The analysis was performed in the UMC Utrecht. Primary outcomes were urinary tract infections (UTIs) and urological complications. Secondary outcomes were catheter reinsertion, readmissions, kidney function, delayed graft function and hospitalization duration. Results: No relevant associations were found for the urethral catheter duration with UTIs, urological complications, catheter reinsertion, readmissions, hospitalization duration, delayed graft function and kidney function. Conclusion: This analysis indicates that changing the urethral catheter duration from five days to three days can be done safely