Urinary catheter management.

After colorectal resection surgery, early urinary catheter removal has been promoted as a part of the national Surgical Care Improvement Project. However, the decrease in urinary tract infection expected with this strategy must be balanced against an increased risk for urinary retention. A systematic review of the literature was undertaken to summarize the evidence for and against early postoperative urinary catheter removal. For nonpelvic colorectal resection, the evidence supports removal of the catheter on postoperative day 1 for patients who are not at high risk for urinary retention, including patients with thoracic epidurals. For mid-to-low rectal surgery, the risk of urinary retention is increased, and catheter removal on day 3 to day 6 is recommended; however, the exact timing of removal cannot be recommended based on current studies.