Rate of Postoperative Urinary Retention After Anterior Compartment Prolapse Surgery: a Randomized Controlled Trial Comparing Early Versus Conventional Transurethral Catheter Removal

Abstract Purpose To compare the rate of postoperative urinary retention (POUR) after anterior prolapse surgery between early transurethral catheter removal (24 hours postoperatively) and our standard practice (on postoperative day 3)Methods We conducted a randomized controlled trial among patients undergoing anterior compartment prolapse surgery between 2020 and 2021 at a university hospital. Women were randomized into two groups. After removal, if the second void residual urine volume exceeded 150 mL, POUR was diagnosed and intermittent catheterization was performed. The primary outcome was the POUR rate. The secondary outcomes included urinary tract infection, asymptomatic bacteriuria (AB), time to ambulation, time to spontaneous voiding, length of hospitalization, and patient satisfaction.Results Sixty-eight women were enrolled. There were no significant differences in baseline characteristics, intraoperative blood loss, operative time, anesthetic modalities, opioid use, and complications. The overall POUR rate was 29.4%. The POUR rate in the conventional group was 18.2% higher than that in the early-removal group; however, this was not statistically significant. (32.4% vs. 26.5%, RR 0.82; 95% CI: 0.39–1.72). There was no significant difference between groups for postoperative AB rate (14.7 vs. 0%, p=0.053). The early-removal group had shorter lengths of hospital stay (1 day vs. 3 days, p<0.001) and 3.8 hours earlier time to ambulation (p=0.2), without significant differences in postoperative patient satisfaction. Conclusion Among patients undergoing anterior compartment prolapse surgery, early catheter removal was comparable in POUR rate to conventional treatment, with shorter hospitalization. Therefore, early transurethral catheter removal is preferable following anterior compartment prolapse surgery. Clinical trial registration number thaiclinicaltrials.org, TCTR20210309003, 09 March 2021, retrospectively registered.

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Subcutaneous Tunnelling of Epidural Catheters for Postoperative Analgesia to Prevent Accidental Dislodgement: A Randomized Controlled Trial

Anaesthesia and Intensive Care ◽

10.1177/0310057x9802600203 ◽

1998 ◽

Vol 26 (2) ◽

pp. 147-151 ◽

Cited By ~ 16

Author(s):

R. Burstal ◽

F. Wegener ◽

C. Hayes ◽

G. Lantry

Keyword(s):

Randomized Controlled Trial ◽

Postoperative Analgesia ◽

Controlled Trial ◽

Initial Position ◽

Catheter Removal ◽

Standard Group ◽

Epidural Blockade ◽

Randomized Controlled ◽

Clinically Significant ◽

Epidural Catheters

The use of subcutaneous tunnelling to prevent movement of epidural catheters was examined in a prospective controlled trial. There were 113 patients in the standard group and 100 in the tunnelled group. The groups were similar with respect to age, sex and weight. There were 176 thoracic catheters, and 37 lumbar catheters. Mean duration of catheterization in the tunnelled group was 3.5±1.3 days and in the standard group, 3.1±1.5 days. In total, 60 catheters moved significantly from their initial position: 17 (28%) moved inwards and 43 (72%) moved outwards. 159 catheters were still functioning at the time of their removal, 76 standard and 83 tunnelled. This represents 67 and 83% of the two groups respectively. Subcutaneous tunnelling was shown to prevent clinically significant inwards (P=0.043) and outwards (P=0.0005) movement of epidural catheters and is more likely to result in a functional epidural blockade at the time of catheter removal (P=0.0084).

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