Removal of Indwelling Catheter Following Benign Laparoscopic Hysterectomy: Does Timing Matter?

Study Objective It is standard procedure to place an indwelling catheter during a benign laparoscopic hysterectomy. However, timing of removal after surgery remains controversial due to risk of UTI and recatheterization. This study investigated if the timing of foley removal influenced clinical outcomes and factors influencing timing of removal. Design Retrospective study. Setting Single center hospital. Patients or Participants 281 women that underwent benign laparoscopic hysterectomy in 2018 and did not require bladder suspension and concomitant vaginal surgery. Interventions Foley removal occured either immediately after surgery in the operating room (ICR), or delayed catheter removal (DCR) either in the post-anesthesia care unit (PACU) – (DCR-PACU) or on post-operative day one (DCR-POD1). Measurements and Main Results There were 108 patients in the ICR group, 22 patients in the DCR-PACU group and 151 patients in the DCR-POD1 group. Baseline characteristics such as BMI, age, indications for hysterectomy, uterine weight, and ASA class were similar. DCR-POD1 group patients had longer operative times compared to ICR and DCR-PACU, 158 vs 120 vs 115 minutes, (p-value Conclusion Although ICR was associated with higher urinary retention rate, this did not appear to be statistically significant when the use of scopolamine patch and case complexity was controlled for. ICR should still be considered so as to maximize the benefits of minimally invasive surgery and increase patient satisfaction.