Timing of urinary catheter removal after uncomplicated total abdominal hysterectomy: a prospective randomized trial

Objective: To assess whether immediate (0 h), intermediate (after 6 h) or delayed (after 24 h) removal of an indwelling urinary catheter after uncomplicated abdominal hysterectomy can affect the rate of recatheterization due to urinary retention, rate of urinary tract infection, ambulation time and length of hospital stay. Study design: Prospective randomized controlled trial conducted at Suez Canal University Hospital, Egypt. Two hundred and twenty-one women underwent total abdominal hysterectomy for benign gynecological diseases and were randomly allocated into three groups. Women in group A (73 patients) had their urinary catheter removed immediately after surgery. Group B (81 patients) had the catheter removed 6 h post-operatively while in group C (67 patients) the catheter was removed after 24 h. The main outcome measures were the frequency of urinary retention, urinary tract infections, ambulation time and length of hospital stay. Results: There was a significantly higher number of urinary retention episodes requiring recatheterization in the immediate removal group compared to the intermediate and delayed removal groups (16.4% versus 2.5% and 0% respectively). Delayed urinary catheter removal was associated with a higher incidence of urinary tract infections (15%), delayed ambulation time (10.3 h) and longer hospital stay (5.6 days) compared to the early (1.4%, 4.1 h and 3.2 days respectively) and intermediate (3.7%, 6.8 h and 3.4 days respectively) removal groups. Conclusions: Removal of the urinary catheter 6 h postoperatively appears to be more advantageous than early or late removal in cases of uncomplicated total abdominal hysterectomy. (C) 2014 Elsevier Ireland Ltd. All rights reserved.