Pelvic laparotomy without an indwelling catheter. A retrospective review of 949 cases.

A retrospective review of 949 cases of pelvic laparotomy without an indwelling catheter was conducted. Contrary to traditional beliefs, this study found that the use of an indwelling catheter was not necessary to assure either adequate exposure during operation or satisfactory voiding in the postoperative period. Various prophylactic steps included staff attention to the preoperative and postoperative voiding needs of patients and occasional bladder needling during operation. These efforts resulted in a low (22.1%) postoperative distress catheterization rate with no complications if needling was done. Urinary infection rates ranged from less than 1% for patients who did not require distress catheterization to 3.9% for a comparative population of patients who had an indwelling catheter during and after operation. Abstaining from the use of an indwelling catheter was also associated with lower cost and greater patient satisfaction.