A prospective randomized trial to compare side effects of early versus late removal of Foley’s catheter and vaginal pack following vaginal hysterectomy
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20182865Keywords:
Foley’s catheter, Recatheterization, Urinary infection, Vaginal packAbstract
Background: There is a controversy about the ideal time for removal of catheter and vaginal pack following vaginal hysterectomy. The present study was undertaken to compare post-operative morbidity in early and late removal of Foley’s catheter and vaginal pack. The aim of this study is to compare post-operative morbidity in early and late removal of Foley’s catheter and vaginal pack following vaginal hysterectomy.
Methods: This was a prospective randomized study with n=100 of those women who were undergoing vaginal hysterectomy with or without pelvic floor repair and fulfilled the inclusion criteria. After informed written consent, they were assigned to Foley’s catheter and vaginal pack removal group in 6 hours (group I, n=50) or 24 hours removal group (group II, n=50). Primary parameters used to assess were urine routine and microscopy, urine culture and sensitivity on post-operative day 2, need for re-catheterization and repacking, febrile morbidity, ambulation, vault infection and post-operative hospital stay duration were analyzed in both groups.
Results: Febrile morbidity was found in 6% and 8%, Positive urine culture was found in 10% and 20%, Rate of re-catheterization was 10% in group I and group II respectively. Vaginal bleeding after pack removal and repacking was in 6% in group I whilst none had in group II.
Conclusions: Early removal was associated with less incidence of urinary tract infection, and increased rate of re-catheterization and repacking. Needs larger comparative studies to support the practice of early removal.
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References
Wu JM, Wechter ME, Geller EJ, Nguyen TV, Visco AG. Hysterectomy rates in the United States, 2003. Obstet and Gynecol. 2007 Nov 1;110(5):1091-5.
American College of Obstetricians and Gynecologists. Choosing the route of hysterectomy for benign disease. ACOG Committee Opinion. 2009 Nov(444):1156-8.
Linkov F, Sanei-Moghaddam A, Edwards RP, Lounder PJ, Ismail N, Goughnour SL et al. Implementation of Hysterectomy Pathway: Impact on Complications. Womens Health Issues. 2017 Jul - Aug;27(4):493-8.
Dorsey JH, Steinberg EP, Holtz PM. Clinical indications for hysterectomy route: patient characteristics or physician preference? Am J Obstet Gynecol. 1995;173(5):1452-60.
Schiotz HA. [Catheterization routines after gynecologic surgery in Norway]. Tidsskr Nor Laegeforen. 1991;111(7):841-3.
Warren JW. Catheter-associated urinary tract infections. Infectious disease clinics of North America. 1997;11(3):609-22.
Sekhavat L, Farajkhoda T, Davar R. The effect of early removal of indwelling urinary catheter on postoperative urinary complications in anterior colporrhaphy surgery. Aust N Z J Obstet Gynaecol. 2008;48(3):348-52.
Glavind K, Mørup L, Madsen H, Glavind J. A prospective, randomised, controlled trial comparing 3 hour and 24-hour postoperative removal of bladder catheter and vaginal pack following vaginal prolapse surgery. Acta Obstet Gynecol Scand. 2007;86(9):1122-5.
Summitt RL Jr, Stovall TG, Bran DF. Prospective comparison of indwelling bladder catheter drainage versus no catheter after vaginal hysterectomy. Am J Obstet Gynecol. 1994;170(6):1815-8.
Rajan P, Raghavan SS, Sharma D. Study comparing 3 hour and 24-hour post-operative removal of bladder catheter and vaginal pack following vaginal surgery: a randomised controlled trial. BMC Women's Health. 2017;17:78-83.
Ahmed MR, Sayed Ahmed WA, Atwa KA, Metwally L. Timing of urinary catheter removal after uncomplicated total abdominal hysterectomy: a prospective randomized trial. Eur J Obstet Gynecol Reprod Biol. 2014;176:60-3.
Nahed F. K. Effect of Early versus Late removal of Urinary Catheter on Urinary Outcome after Hysterectomy. J Am Sc. 2011;7(1): 277-81.
Alessandri F, Mistrangelo E, Lijoi D, Ferrero S, Ragni N. A prospective, randomized trial comparing immediate versus delayed catheter removal following hysterectomy. Acta Obstetricia et Gynecolog Scandinavica. 2006 Jun;85(6):716-20.
Shrestha B, Marhatha R, Kayastha S, Jaishi S. Short-term versus long-term catheterization after vaginal prolapse surgery. Nepal Medical College J: NMCJ. 2013;15(2):102-05.
Shahnaz A, Elham R, Kambiz A, Sara K. Comparison of 1 Versus 3 Days Post-Operative Catheterization After Anterior Colporrhaphy. Asian J Pharma Res Health Care; 2016:8(S1),1-6.
Thakur N, Gurung G, Rana A. A randomized controlled trial comparing short-term versus long-term catheterization after vaginal prolapse surgery. Nepal J Obstet Gynaecol. 2007;2(1):29-34.
Joshi B, Aggarwal N, Chopra S, Taneja N. A prospective randomized controlled comparison of immediate versus late removal of urinary catheter after abdominal hysterectomy. J Midlife Health. 2014;5(2):68-71.
Subramanya J, Curtiss N, Balachandran A, Duckett J. Should we use a vaginal pack to reduce blood loss at the time of prolapse surgery? Europ J Obstet Gynecol Reprod Biol. 2006;206:181-3.
Thiagamoorthy G, Khalil A, Cardozo L, Srikrishna S, Leslie G, Robinson D. The value of vaginal packing in pelvic floor surgery: a randomised double-blind study. Int Urogynecol J. 2014;25(5):585-91.
Ouladsahebmadarek E, Sayyah-Melli M, Jafari-Shobeiri M. A randomized clinical trial to compare immediate versus delayed removal of foley catheter following abdominal hysterectomy and laparotomy. Pak J Med Sci. 2012;28(3):380-3.
Choudhury FR, Rashid M, Rumana R, Uddin AZ, Ava NN. Short Term Versus Long Term Catheterization after Urogenital Prolapse Surgery. J Shaheed Suhrawardy Med College. 2012 Oct;3(2):41-3.
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