A Comparison of Suprapubic and Transurethral Catheterization on Postoperative Urinary Retention after Vaginal Prolapse Repair: A Randomized Controlled Trial

Abstract

Aim: To compare the effect of suprapubic and transurethral catheterization on postvoid residual volumes (PRVs) after cystocele repair. Methods: 126 women who underwent pelvic organ prolapse surgery including cystocele repair were randomized to suprapubic or transurethral catheterization. At the third postoperative day, PRVs were measured. The number of women with PRV >150 ml, need for prolonged catheterization, recatheterization, length of hospital stay, frequency of urinary tract infections and complications were determined. Results: PRVs exceeded 150 ml in 13 out of 64 (20%) and 14 out of 62 (23%) women in the suprapubic and transurethral group, respectively (p = 0.76). In the suprapubic group a higher rate of urine leakage was noted (27 vs. 7%, p = 0.003). 10 women (16%) allocated to the suprapubic group switched to transurethral catheterization, because of problems with the suprapubic catheter. No protocol deviations were reported in the transurethral group. Of the women in both groups, 9% developed urinary tract infections (p = 0.93). Conclusions: Suprapubic catheterization was comparable to transurethral catheterization in the prevention of postoperative voiding dysfunction after vaginal prolapse surgery, but it was associated with a higher rate of complications.