The Feasibility and Safety of No Placement of Urinary Catheter Following Lung Cancer Surgery: A Retrospective Cohort Study With 2,495 Cases

Objectives: The study was aimed to investigate the safety and feasibility of avoiding urinary catheterization after surgery in patients undergoing lung cancer resection. Methods: Between 1 January 2014 and 31 December 2017, the patients with primary lung cancer who received lobectomy or segmental resection via video-assisted thoracic surgery (VATS) in our department were screened. Based on whether a urinary catheter was inserted after surgery, patients were divided into urinary catheter (UC) group or non-UC group, and rates of postoperative urinary retention (POUR), urinary catheter re-insertion and urinary tract infection (UTI) were compared. Results: There was no difference in International prostate symptom score (p = .268) between the groups, but a higher Sedation-Agitation Scale (SAS) score was found in UC group [4.0 (3.0 4.0) vs. 4.0 (2.0, 4.0); p < .001], with a higher proportion of patients with agitation (SAS score > 4; 17.3%, 317/1,835 vs. 12.9%, 86/660, p = .008). In contrast, a higher rate of POUR was observed in non-UC group (11.2%, 74/660 vs. 7.4%, 136/1,835, p = .003), whereas the rate of UTI was significantly lower in this group (5.8%, 38/660 vs. 8.3%, 153/1,835, p = .033). Multivariable analysis revealed the non-placement of UC as the independent factor for POUR (OR: 1.542, 95%CI: 1.135-2.095, p = .006) and UTI (OR: 0.664, 95%CI: 0.459-0.962, p = .031). Conclusion: This retrospective study with large sample of 2,495 patients provided evidence to the hypothesis that avoiding urinary catheterization contributed to decrease in the incidence of UTI and was safe and feasible in patients undergoing lung cancer surgery.

Automated summary

The study demonstrated that avoiding urinary catheterization after lung cancer surgery can reduce the incidence of urinary tract infection, while achieving better outcomes in terms of postoperative urinary retention and urinary tract infection compared to catheter insertion.