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Indwelling Versus Immediate Removal of Transurethral Catheter After Robotic Sacrocolpopexy

A Randomized Clinical Trial

Vallabh-Patel, Vaneesha DO; Popiel, Patrick MD; Salamon, Charbel MD, MS

Female Pelvic Medicine & Reconstructive Surgery: October 15, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000646
Original Article: PDF Only
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Introduction and Hypothesis This study evaluates the necessity and effect of an indwelling transurethral catheter in the early postoperative period following a robotic-assisted laparoscopic sacrocolpopexy.

Methods This was a randomized clinical trial of patients who underwent a robotic sacrocolpopexy for pelvic organ prolapse. Patients were randomized to have their transurethral catheter removed 6 hours postoperative (intervention group) or the morning following surgery (control group). Our primary outcome was to compare the number of patients diagnosed with postoperative incomplete bladder empyting in each group. A sample size of 36 patients per group was needed to detect a 25% difference between the 2 groups. Anticipating a 20% patient withdrawal rate, we estimated that we would need a total of 88 participants. Outcome variable was analyzed using χ2 test, Fisher exact test, Mann-Whitney U test, 2-proportions test, and 2-sample t test.

Results From December 2015 through May 2017, 88 women were randomized and analyzed: 44 in the intervention group and 44 in the control group. Women in the intervention group were more likely to be diagnosed with incomplete bladder emptying, 14 (31%) of 44, compared with the control group, 2 (4.5%) of 44, P <0.001. Rate of urinary tract infections within the 30-day postoperative period was also increased in the intervention group, 4 (9%) of 44, compared with 0 in the control group. Postoperative complications were similar between groups.

Conclusions In women undergoing a robotic sacrocolpopexy, early transurethral catheter removal (6 hours postoperative) is associated with an increased rate of incomplete bladder emptying, recatheterization, and urinary tract infections.

From the Division of Urogynecology and Female Reconstructive Surgery, Atlantic Health System, Morristown, NJ.

Correspondence: Vaneesha Vallabh-Patel DO, 435 South St, Suite 370, Morristown, NJ 07960. E-mail: Vaneesha.Vallabh@gmail.com.

Funding was provided through a grant from Morristown Medical Center Research Foundation.

This study was presented at the American Urogynecologic Society's 38th Annual Scientific Meeting; Providence, RI; October 2017.

The authors declare that they have no conflict of interest.

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