PURPOSE: Urinary bladder drainage for several days after pelvic surgery is a common surgical practice, despite insufficient evidence supporting its routine use. The aim of this study was to prospectively evaluate the utility of urinary bladder drainage after pelvic colorectal surgery.
METHODS: Patients undergoing pelvic surgery were prospectively randomly assigned to 3 groups. In group A, the Foley catheter was removed on postoperative day 1, and in groups B and C it was removed on postoperative days 3 and 5, respectively. Male patients with severe prostatic symptoms were excluded from the study. The main outcome criterion was acute urinary retention requiring reinsertion of the Foley catheter.
RESULTS: A total of 118 patients (68 males) at a mean age of 55 years were included in this study (group A, 41 patients; group B, 38; and group C, 39). Overall, urinary retention after removal of the Foley catheter occurred in 12 (10%) of the patients: 6 (14.6%) in group A, 2 (5.3%) in group B, and 4 (10.5%) in group C (P = .39). Symptomatic urinary tract infection was diagnosed in 5 patients in group A, 3 in group B, and 9 in group C, but this difference did not reach statistical significance. Likewise, there were no significant differences in anastomotic leak and intra-abdominal abscess rates among the 3 groups.
CONCLUSIONS: Routine prolonged urinary bladder catheterization after pelvic surgery may not be required, and the Foley catheter may be safely removed on postoperative day 1. Larger studies are needed to confirm the findings of this study.
1 Department of Surgery and Transplantation, Sheba Medical Center, Tel Hashomer, Israel
2 Department of Surgery, University of Alexandria, Alexandria, Egypt
3 Department of Surgery and Colorectal Surgery Unit, Tel Aviv-Sorasky Medical Center, Tel Aviv, Israel
Financial Disclosure: None reported.
Presented at the meeting of The American Society of Colon and Rectal Surgeons and Tripartite, Boston, MA, June 7 to 11, 2008.
Correspondence: Oded Zmora, M.D., Department of Surgery and Transplantation, Sheba Medical Center, Tel-Hashomer 52621, Israel. E-mail: firstname.lastname@example.org