Comparison the efficacy of immediate versus delayed removal of urinary catheter after hysterectomy : a Meta-analysis

Abstract

Objective To evaluate the efficacy of immediate and delayed postoperative removal of urethral catheters Methods Randomized controlled trials and quasi-experiment trails of immediate and delayed postoperative removal of urethral catheters were collected in the databases such as CENTRAL, PubMed, OVID, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), VIP, Wanfang Data, etc. Data were analyzed by RevMan 5.3 version. after heterogeneity analysis, pooled risk ratio (RR) with 95% confidence interval (95%CI) using both fixed and random effect models were estimated. Results Ten randomized controlled trials (RCTs) were included. The results of Meta-analysis indicated that immediate urinary catheter removal was associated with a lower incidence of urinary tract infections (RR=0.29, 95%CI 0.15 to 0.56, P=0.000 3), positive urinary culture (RR=0.31, 95%CI 0.16 to 0.59, P=0.000 2)compared with the delayed removal group and seven studies recommended removal of the indwelling urinary catheter immediately after hysterectomy. While, there was a higher risk of re-catheterization (RR=4.56, 95% CI 2.93 to 7.08, P <0.01) in the immediate removal group. Seven studies recommended removal of the indwelling urinary catheter immediately after hysterectomy. Conclusions Removal of the indwelling urinary catheter immediately after hysterectomy was recommended. Key words: Urinary catheter; Urinary tract infections; Meta-analysis