• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
Grand Rounds

Immediate or Delayed Catheter Removal After Laparoscopic Hysterectomy?

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • The ideal time to remove an indwelling catheter following an uncomplicated laparoscopic hysterectomy is not well understood
    • Risk of retaining catheter: Increased risk for UTI and prolonged hospital stay
    • Benefit of retaining catheter: Less risk for urinary retention
  • Sandberg et al. (BJOG, 2019) compared immediate catheter removal (ICR) vs delayed catheter removal (DCR) following laparoscopic hysterectomy

METHODS:

  • Non-inferiority randomized controlled trial
  • Participants
    • Women undergoing laparoscopic hysterectomy in the Netherlands
    • Uncomplicated surgery
  • Groups (randomized)
    • ICR group: Immediate catheter removal post-op
    • DCR group: Delayed catheter removal between 18 and 24 hours post-op
  • Primary outcome
    • Urinary retention: Inability to void completely within 6 hours after catheter removal | Retention measured via bladder scan
  • Secondary outcomes
    • UTI (based nitrite, leucocytes and clinical symptoms) | time to mobilization (first time out of bed) | Length of hospital stay | Self‐developed questionnaires 6 hours, 24 hours and 6 weeks post-op

RESULTS:

Urinary Retention

  • ICR group = 74 | DCR group = 81 women
  • ICR was not found to be non-inferior to DCR for primary outcome
    • ICR group with urinary retention: 13.5% (10 women)
    • DCR group with urinary retention: 0%
    • Risk difference: 13.5% (95% CI, 5.6 to 24.8)
  • ICR group: Seven of the 10 women voided within 9 hours
  • DCR group: 9.9% of women requested catheter removal prior to 18 hours due to discomfort (between 2 to 12 hours)

UTI

  • ICR group: 4.1% (3 women)
  • DCR group: 9.9% (8 women)
  • Risk difference: −5.8% (95% CI, −15.1 to 3.5)

Mobilization

  • Women with ICR mobilized significantly earlier (P ≤ 0.001)
  • ICR group: 5.7 hours (range, 0.8 to 23.3)
  • DCR group: 21.0 hours (range, 1.4 to 29.9)

CONCLUSION:

  • Using a non-inferior study design, immediate catheter removal did not prove to be an equivalent option to delayed removal
    • Authors question whether the observed urinary retention cases were clinically relevant considering that 70% of women in the ICR did end up voiding at 9 instead of 6 hours
  • Advantages of ICR (e.g., mobilization) may still outweigh the risk of bladder retention following laparoscopic hysterectomy

Learn More – Primary Sources:

Immediate versus delayed removal of urinary catheter after laparoscopic hysterectomy: a randomised controlled trial

Now You Can Get ObG Clinical Research Summaries Direct to Your Phone, with ObGFirst

Learn More »

image_pdfFavoriteLoadingFavorite
< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

Can Epidural be an Alternative to General Anesthesia for Laparoscopic Hysterectomies?
Abdominal or Laparoscopic Hysterectomy for a Woman with an Enlarged Uterus?
Which Surgeries are Most Likely to Lead to Urinary Tract Injury?

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Download Your ObG App
HERE!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site