Home Removal of Urinary Catheters After Pelvic Floor Reconstruction Surgery.

INTRODUCTION AND HYPOTHESIS: This study is aimed at comparing home with hospital removal of urinary catheters after surgical correction of pelvic floor disorders.

METHODS

This is a retrospective cohort study at a single urogynecology practice (1 May 2020 to 30 November 2024). A total of 184 patients, age 33-86 years (mean 66.2) with a diagnosis of pelvic floor disorder underwent home removal (primary n = 31, secondary n = 34) or hospital removal (n = 153) of a urinary catheter after pelvic floor reconstructive surgery (IRB Pro2024-0473).

RESULTS

The incidence of urinary retention was significantly lower in the primary home-removal group (3.3% ± 3.3%, n = 1, 95% CI 0-9.8%) compared with the hospital-removal group (27.5% ± 3.6%, n = 42, 95% CI 20.3-34.6%; p = 0.004). Of those with urinary retention, most underwent home removal for a secondary void trial (n = 34, 81.0%). The incidence of catheter-associated urinary tract infections (CAUTIs) was increased but not statistically significantly in the primary home-removal group (22.6% ± 7.6%, 95% CI 7.0-38.2%) compared with the hospital-removal group (9.2% ± 2.3%, 95% CI 4.5-13.8%; p = 0.056). The duration of the primary hospital admission was significantly shorter for the home removal of urinary catheterization (0.3 ± 0.1 day vs 1.1 ± 0.1 day; p < 0.0001). There was no significant difference in readmission (p = 0.593) or return to the operating room (p > 0.999).

CONCLUSIONS

Home catheter removal after pelvic floor reconstructive surgery appears feasible in selected patients and is associated with reduced hospital utilization and lower urinary retention rates. However, a trend toward increased CAUTIs cannot be dismissed. Therefore, prospective randomized trials are needed to definitively establish safety and identify appropriate patient selection criteria before widespread adoption.