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Reducing postoperative catheterisation after anterior colporrhaphy from 48 to 24 h: a randomised controlled trial

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Abstract

Introduction and hypothesis

There is a distinct lack of literature on postoperative management after anterior colporrhaphy (AC). Our traditional postoperative protocol consisted of 24 h of indwelling catheterisation followed by 24 h of self-intermittent catheterisation. We hypothesised that a new protocol consisting of only 24 h of indwelling catheterisation might produce better results without additional complications.

Methods

From April 2014 to July 2017, all candidates for AC were randomised to catheter removal 24 or 48 h after surgery. The primary outcome was the postoperative urinary retention (POUR) rate. Secondary outcomes included: asymptomatic bacteriuria (AB), urinary tract infection (UTI) and postoperative pain after 24 h.

Results

A total of 79 patients were recruited. Thirty-seven and 40 patients were randomised to follow the 48-h protocol and the 24-h protocol respectively. There were no significant differences in relation to the POUR rate: 3 patients (8.1%) vs 1 (2.5%) in the 48-h vs the 24-h group respectively (p = 0.346). The UTI rate was 2 (8.1%) vs 0 patients respectively (p = 0.139) and the postoperative AB rate was 3 (9.1%) vs 0 patients (p = 0.106). In the postoperative pain evaluation, the visual analogue scale score was significantly higher in the 48 h group (0.35 vs 0.13, p = 0.02).

Conclusions

According to our results, reducing the catheterisation from 48 to 24 h after AC does not increase the risk of POUR and decreases the rate of UTI, AB and postoperative pain. This new postoperative management protocol of pelvic floor surgery would improve postoperative outcomes and shorten the stay in hospital.

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References

  1. Maher C, Feiner B, Baessler K, Haya N, Brown J. Surgery for women with anterior compartment prolapse (review) summary of findings for the main comparison. Cochrane Database Syst Rev 2016;11:CD004014.

    PubMed  Google Scholar 

  2. Hakvoort RA, Burger MP, Emanuel MH, Roovers JP. A nationwide survey to measure practice variation of catheterisation management in patients undergoing vaginal prolapse surgery. Int Urogynecol J. 2009;20(7):813–8.

    Article  CAS  Google Scholar 

  3. Haylen BT, Freeman RM, Lee J, Swift SE, Cosson M, Deprest J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint terminology and classification of the complications related to native tissue female pelvic floor surgery. Neurourol Urodyn. 2012;31:406–14.

    Article  Google Scholar 

  4. Glavind K, Morup 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.

    Article  Google Scholar 

  5. Weemhoff M, Wassen MMLH, Korsten L, Serroyen J, Kampschöer PHNM, Roumen FJME. Postoperative catheterization after anterior colporrhaphy: 2 versus 5 days. A multicentre randomized controlled trial. Int Urogynecol J. 2011;22(4):477–83.

    Article  Google Scholar 

  6. Hakvoort RA, Elberink R, Vollebregt A, Ploeg T, Emanuel MH. How long should urinary bladder catheterisation be continued after vaginal prolapse surgery? A randomised controlled trial comparing short term versus long term catheterisation after vaginal prolapse surgery. BJOG. 2004;111(8):828–30.

    Article  CAS  Google Scholar 

  7. Bray R, Cartwright R, Digesu A, Fernando R, Khullar V. A randomised controlled trial comparing immediate versus delayed catheter removal following vaginal prolapse surgery. Eur J Obstet Gynecol Reprod Biol. 2017;210:314–8. https://doi.org/10.1016/j.ejogrb.2017.01.015.

    Article  PubMed  Google Scholar 

  8. Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29:4–20.

    PubMed  Google Scholar 

  9. Espuña M, Rebollo PPM. Validation of the Spanish version of the International Consultation on Incontinence Questionnaire-Short Form. A questionnaire for assessing the urinary incontinence. Med Clin. 2004;122:288–92.

    Article  Google Scholar 

  10. Sánchez-Sánchez B, Torres-Lacomba M, Yuste-Sánchez MJ, Navarro-Brazález B, Pacheco-da-Costa S, Gutiérrez-Ortega C, et al. Cultural adaptation and validation of the Pelvic Floor Distress Inventory Short Form (PFDI-20) and Pelvic Floor Impact Questionnaire Short Form (PFIQ-7) Spanish versions. Eur J Obstet Gynecol Reprod Biol. 2013;170(1):281–5.

    Article  Google Scholar 

  11. Mestre M, Lleberia J, Pubill J, Espuña-Pons M. Spanish version of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire IUGA-Revised (PISQ-IR): transcultural validation. Int Urogynecol J. 2017;28(12):1865–73.

    Article  Google Scholar 

  12. Haylen BT, Maher CF, Barber MD, Camargo S, Dandolu V, Digesu A, et al. Erratum to: an International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). Int Urogynecol J. 2016;27(4):655–84.

    Article  Google Scholar 

  13. Dicuio M, Pomara G, Menchini Fabris F, Ales V, Dahlstrand CMG. Measurements of urinary bladder volume: comparison of five ultrasound calculation methods in volunteers. Arch Ital Urol Androl. 2005;77(1):60–2.

    PubMed  Google Scholar 

  14. Kringel U, Reimer T, Tomczak S, Green S, Kundt G, Gerber B. Postoperative infections due to bladder catheters after anterior colporrhaphy: a prospective, randomized three-arm study. Int Urogynecol J. 2010;21(12):1499–504.

    Article  Google Scholar 

  15. Phipps S, Lim YN, McClinton S, Barry C, Rane A, N’Dow JM. Short term urinary catheter policies following urogenital surgery in adults. Cochrane Database Syst Rev. 2006;2:CD004374.

    Google Scholar 

  16. Saaby ML, Lose G. Repeatability of post-void residual urine ≥ 100 ml in urogynaecologic patients. Int Urogynecol J. 2012;23(2):207–9.

    Article  Google Scholar 

  17. Haylen BT, Lee J. The accuracy of post-void residual measurement in women. Int Urogynecol J. 2008;19(5):603–6.

    Article  Google Scholar 

  18. Wang R, Won S, Haviland MJ, Von Bargen E, Hacker MR, Li J, et al. Voiding trial outcome following pelvic floor repair without incontinence procedures. Int Urogynecol J. 2016;27(8):1215–20.

    Article  Google Scholar 

  19. Hakvoort RA, Dijkgraaf MG, Burger MP, Emanuel MH, Roovers JP. Predicting short-term urinary retention after vaginal prolapse surgery. Neurourol Urodyn. 2009;28:225–8.

    Article  Google Scholar 

  20. Alonzo-Sosa JE, Flores Contreras JT, Paredes-Canul M. Method for transurethral catheterization for 1–3 days for pelvic floor relaxation in the postoperative period. Ginecol Obstet Mex. 1997;65:455–7.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. BCNatal | Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clínic, Institut de Recerca Sant Joan de Déu, c/ Passeig Sant Joan de Déu 2, CP 08950, Esplugues de Llobregat, Barcelona, Spain

    Sergi Fernandez-Gonzalez, Cristina Molinet Coll, Funesanta Ojeda González, Maria Dolores Gómez Roig & Lluís Amat Tardiu

  2. Parc Sanitari Sant Joan de Déu, c/ Cami Vell de la Colonia 25, CP: 08830, Sant Boi de Llobregat, Barcelona, Spain

    Eva Martinez Franco

  3. Consorci Sanitari Garraf, Unitat Sol pelvià, Ronda de Sant Camil, s/n, 08810, Sant Pere de Ribes, Barcelona, Spain

    Rubén Martínez-Cumplido

Authors
  1. Sergi Fernandez-Gonzalez
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  2. Eva Martinez Franco
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  3. Rubén Martínez-Cumplido
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  4. Cristina Molinet Coll
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  5. Funesanta Ojeda González
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  6. Maria Dolores Gómez Roig
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  7. Lluís Amat Tardiu
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Correspondence to Sergi Fernandez-Gonzalez.

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Fernandez-Gonzalez, S., Martinez Franco, E., Martínez-Cumplido, R. et al. Reducing postoperative catheterisation after anterior colporrhaphy from 48 to 24 h: a randomised controlled trial. Int Urogynecol J 30, 1897–1902 (2019). https://doi.org/10.1007/s00192-018-3818-9

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  • DOI: https://doi.org/10.1007/s00192-018-3818-9

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