A prospective randomized trial to compare immediate and 24-hour delayed catheter removal following total abdominal hysterectomy

Abstract

OBJECTIVE: To assess whether early or immediate removal of a 12F in-dwelling Foley catheter after total abdominal hysterectomy affects the level of subjective pain assessment postoperatively. DESIGN: Randomized controlled trial. SETTING: University Hospital. POPULATION: Seventy women underwent total abdominal hysterectomies for various benign gynecological diseases. METHODS: Women were randomized to have the urinary catheter removed in the operating room after the surgical procedure or to have it removed on postoperative day 1. MAIN OUTCOME MEASURES: The primary outcome was patients' pain assessment and the secondary outcomes were rate of re-catheterization and symptomatic urinary tract infection. RESULTS: There was no difference in the pain assessment between the two groups. A significantly higher number of urinary retention episodes requiring re-catheterization were found in the immediate removal group compared with the delayed removal group (20 vs. 0%; p= 0.011). The incidence of symptomatic urinary tract infection did not differ between the two groups. CONCLUSIONS: There are pros and cons regarding the policy of one-day in-dwelling catheterization compared to immediate catheter removal.