Dong Hou1, Zhaoyuan Li2, Shouxin Peng2, Wei Liang3. 1. Department of Intensive Care Unit, Zhenjiang First People's Hospital, 8# Dianli road, Zhenjiang, China. 2. School of Public Health, Wuhan University, 115#Donghu Road, Wuhan, China. 3. School of Public Health, Wuhan University, 115#Donghu Road, Wuhan, China. weiweiliang18@163.com.
Abstract
INTRODUCTION AND HYPOTHESIS: The optimal timing for removing urinary catheters is controversial for patients undergoing total hysterectomy. This study aimed to evaluate the optimal time for removing urinary catheters post-hysterectomy. METHODS: We searched multiple databases from inception till December 31, 2020, for all randomized trials evaluating the timing of catheter removal following hysterectomy. All studies were evaluated by two investigators independently depending on inclusion and exclusion criteria. Network meta-analysis (NMA) was conducted on the data using Stata 14.0 software. RESULTS: A total of 12 articles involving 1814 patients were ultimately included. This study showed removing urinary catheters 12.1 to 24 h (pooled OR = 2.67; 95% CI, 1.53‑4.67) and 36.1 to 48 h (pooled OR = 8.11;95% CI, 3.78‑17.36) post-hysterectomy increased the risk of urinary tract infection (UTI) compared with immediate catheter removal. Timing of catheter removal in other groups following hysterectomy accompanied a reduced risk of urinary retention (UR) versus immediate catheter removal (P < 0.05). Removal of the urinary catheter from 36.1 to 48 h was most likely to lead to UTI. The maximum SUCRA value of immediate catheter removal after hysterectomy was 99.3% for UR. Catheter removal 24.1 to 36 h after hysterectomy was the best time for preventing UR. CONCLUSION: Removal of the catheter immediately after hysterectomy may be the optimal time for preventing UTI with increased risk of UR, whereas removal time of the urinary catheters within 6 h post-hysterectomy combined with postoperative urination monitoring might be more beneficial than other removal times following hysterectomy.
INTRODUCTION AND HYPOTHESIS: The optimal timing for removing urinary catheters is controversial for patients undergoing total hysterectomy. This study aimed to evaluate the optimal time for removing urinary catheters post-hysterectomy. METHODS: We searched multiple databases from inception till December 31, 2020, for all randomized trials evaluating the timing of catheter removal following hysterectomy. All studies were evaluated by two investigators independently depending on inclusion and exclusion criteria. Network meta-analysis (NMA) was conducted on the data using Stata 14.0 software. RESULTS: A total of 12 articles involving 1814 patients were ultimately included. This study showed removing urinary catheters 12.1 to 24 h (pooled OR = 2.67; 95% CI, 1.53‑4.67) and 36.1 to 48 h (pooled OR = 8.11;95% CI, 3.78‑17.36) post-hysterectomy increased the risk of urinary tract infection (UTI) compared with immediate catheter removal. Timing of catheter removal in other groups following hysterectomy accompanied a reduced risk of urinary retention (UR) versus immediate catheter removal (P < 0.05). Removal of the urinary catheter from 36.1 to 48 h was most likely to lead to UTI. The maximum SUCRA value of immediate catheter removal after hysterectomy was 99.3% for UR. Catheter removal 24.1 to 36 h after hysterectomy was the best time for preventing UR. CONCLUSION: Removal of the catheter immediately after hysterectomy may be the optimal time for preventing UTI with increased risk of UR, whereas removal time of the urinary catheters within 6 h post-hysterectomy combined with postoperative urination monitoring might be more beneficial than other removal times following hysterectomy.
Authors: Evelien M Sandberg; Fleur S Leinweber; Petra J Herbschleb; Dorien M A Berends-van der Meer; Frank Willem Jansen Journal: J Obstet Gynaecol Date: 2018-06-08 Impact factor: 1.246
Authors: Michael P Rimmer; Ian Henderson; Stephen D Keay; Khalid S Khan; Bassel H Al Wattar Journal: Eur J Obstet Gynecol Reprod Biol Date: 2020-01-22 Impact factor: 2.435