Timing of Indwelling Catheter Removal and its Impact on Postoperative Urinary Retention Following Prolapse Surgery.

INTRODUCTION AND HYPOTHESIS: Postoperative urinary retention (POUR) is a common complication in prolapse surgery patients. However, there is no consensus regarding the optimal timing for postoperative indwelling urinary catheter (IUC) removal. To provide effective and evidence-based healthcare, we compare same-day midnight removal with IUC removal the morning after surgery.

METHODS

In this retrospective cohort study, 602 patients who underwent prolapse surgery between January 2020 and September 2023 were included. In the early removal group (n = 309), the IUC was removed at midnight on the day of the surgery; in the late removal group (n = 293), it was removed the following morning. Information regarding risk factors for POUR and discharge time was retrieved and analyzed.

RESULTS

No differences regarding the risk of POUR were found between the early and late removal groups OR 1.05 (95% CI 0.68, 1.60). An increased Charlson Comorbidity Index (CCI), stage III and IV prolapse, longer surgery time, spinal anesthesia, and pain are considered independent risk factors for POUR; a higher body mass index (BMI) reduces the risk of POUR. Patients diagnosed and treated for urinary retention had a significantly higher chance of developing urinary tract infections during recovery. Patients within the early removal groups were discharged approximately 9 h earlier.

CONCLUSIONS

Midnight removal of the IUC after prolapse surgery does not lead to an increased incidence of POUR and is considered a safe alternative for catheter removal the following morning. In addition, this may contribute to more effective healthcare and optimization of hospital capacity.