Early Catheter Removal Research Articles

The Less is More Approach: Trailblazing enhanced recovery after laparoscopic colposuspension with early catheter removal

The Less is More Approach: Trailblazing enhanced recovery after laparoscopic colposuspension with early catheter removal

Early removal of urinary catheter in patients with epidural anaesthesia after elective colonic surgery

Early removal of urinary catheter in patients with epidural anaesthesia after elective colonic surgery

Early Urinary Catheter Removal After Lumbar Fusion Surgery – a Quality Improvement Initiative

Early Urinary Catheter Removal After Lumbar Fusion Surgery – a Quality Improvement Initiative

Mortality predictors and definition proposal for complicated coagulase-negative Staphylococcus bacteraemia: a multicentre prospective cohort study.

The study aimed to explore a definition for complicated coagulase-negative staphylococci bloodstream infections (CoNS BSIs) and to identify predictors for mortality. A prospective cohort study was conducted from October 2016 to March 2017 in 26 Spanish hospitals. Complicated CoNS BSI criteria included lack of early catheter removal in catheter-related cases, foreign indwelling implant, persistent bacteraemia, fever ≥72hours on active therapy, metastatic infection or deep-seated focus, and infective endocarditis. Independent predictors for 30-day mortality were evaluated by Cox regression, and the impact of the definition of complicated bacteraemia was assessed. Overall, 445 CoNS BSI cases were included; catheter-related infections were predominant (336/445, 75.5%). Complicated bacteraemia was identified in 240 of 445 patients (53.9%); 30-day mortality in complicated and uncomplicated cases was 53 of 240 (22.1%) and 24/205 (11.7%), respectively (p 0.004). Predictors of 30-day mortality identified in the multivariate analysis included age (hazard ratio [HR]: 1.03, 95% CI: 1.01-1.05), cerebrovascular disease (HR: 2.58, 95% CI: 1.45-4.58), immunosuppressive therapy (HR: 2.16, 95% CI: 1.22-3.84), SOFA score (HR: 1.09, 95% CI: 1.03-1.16), and complicated bacteraemia (HR: 2.14, 95% CI: 1.29-3.53). A catheter-related source of bacteraemia was found to be protective (HR: 0.49, 95% CI: 0.30-0.80). When specific criteria to define complicated bacteraemia were included, fever ≥72hours was associated with an increased risk of death (HR: 2.52, 95% CI: 1.52-4.17) and early catheter removal was protective (HR: 0.47, 95% CI: 0.26-0.83). A high proportion of patients presented complicated bacteraemia according to the proposed criteria; these patients had higher hazards for mortality. Other mortality predictors were identified. Further studies would be needed to validate the proposed criteria.

A rare case of refractory ascites due to aortic regurgitation delaying peritoneal dialysis catheter removal after renal transplantation

Introduction Removing the peritoneal dialysis (PD) catheter after transplantation is necessary in order to improve quality of life after transplantation. However, there is no consensus on the best timeframe of PD-catheter removal in transplanted patients. Early removal can lead to the absence of dialysis access in case of graft failure. However, late removal is associated with significant infectious risk given the immunosuppression. Herein, we describe an exceptional case of refractory ascites secondary to aortic regurgitation in a cirrhotic patient, delaying the removal of his PD catheter. Case reportWe describe the case of a 49-year old patient, with Child B cirrhosis and end-stage kidney disease on chronic peritoneal dialysis who benefited from kidney transplantation. The scheduled PD catheter flushes were marked by the drainage of ascitic fluid, leading to the postponement of the PD catheter removal. The ascites, thought to be secondary to his long-known cirrhosis, was refractory to optimal drug treatment and the PD catheter was used to remove ascites periodically. As a transjugular intrahepatic portosystemic shunt was planned, a severe aortic regurgitation was diagnosed. After aortic valve replacement, the ascites completely disappeared, and the PD catheter could be removed.DiscussionHeart failure represents only 3% of all refractory ascites. Furthermore, left-side heart failure causing ascites but without signs of right-side heart failure has only been described once in the medical literature. Patients with ascites and kidney failure on PD can safely be managed through the PD catheter instead of recurrent paracentesis. However, in transplanted patients especially, keeping the catheter in place brings significant infectious risk. ConclusionWe described an unusual case of refractory ascites after renal transplantation, due to aortic valve regurgitation. This case highlights the importance of weighing the pros and cons of early PD catheter removal, as PD catheter might be useful as a means of removing ascites.

Does prophylactic tamsulosin use with ERAS protocol provide improvement after colorectal surgery?

IntroductionEarly urinary catheter removal has been incorporated into Enhanced Recovery After Surgery (ERAS) pathways to aid faster recovery and minimize urinary tract infection. However, early catheter removal can result in urinary retention, which may lead to catheter reinsertion and a prolonged hospital stay. Tamsulosin, an alpha-blocking medication, effectively treats urinary retention in both men and women. Our study aims to compare urinary retention rates and short-term outcomes between patients treated with tamsulosin and those who were not. MethodsThis retrospective cohort study included patients who underwent elective abdominopelvic colorectal procedures using the ERAS protocol between September 2020 and October 2023. After April 2022, postoperative 0.4 ​mg tamsulosin treatment was added to the ERAS protocol. Univariate analysis was used to compare demographics and perioperative treatment history. The control and tamsulosin groups were matched in a 2:1 ratio, using propensity scores. The primary outcomes were urinary retention and the length of hospital stay. ResultsThe study included 2072 patients (1215 female, 58.6 ​%), with a mean age of 53.1 (±17.1) years. The initial univariate analysis was followed by propensity score matching, resulting in 344 patients in the tamsulosin group and 688 in the control group. The urinary retention rate was notably lower in patients who received tamsulosin during hospitalization (9.2 ​% vs. 4.7 ​%, p ​= ​0.01). Furthermore, the length of hospital stay was shorter in patients treated with tamsulosin (5 vs. 4.2 p ​< ​0.01). ConclusionPostoperative prophylactic tamsulosin use decreases urinary retention rates and length of stay after colorectal surgery and should be considered complementary to ERAS protocols for improved recovery.

Association between duration of urinary catheterization and post-operative mobilization following elective cesarean section: A retrospective case-control study in Espoo, Finland.

Cesarean section is the most common surgery performed on women. The enhanced recovery recommendations are early urinary catheter removal and early mobilization, as essential elements of post-operative care. This study aimed to analyze the association between these elements and whether limiting the catheter treatment duration affects the timing of post-operative mobilization. This retrospective case-control study compared the mobilization of healthy elective cesarean patients under different instructions on urinary catheter removal: cases with a preset catheter removal time (8-12 hours) and controls with catheter removal based on midwife considerations. Apart from the preset time of catheter removal, the routine post-operative care was given by the same personnel without any advice on patient mobilization. Data on patient demographics, surgery details, post-operative medication, first upright mobilization, the length of hospital stay, and patient satisfaction were analyzed. The study comprised 52 cases and one control for each case (N=104). The mean duration of urinary catheterization was 20.15 ± 6.59 and 11.30 ± 4.20 hours in the control and intervention groups, respectively (p<0.001). A linear regression analysis showed a significant association between the catheter removal time and patient mobilization, when adjusted for maternal background parameters (age, BMI, fear of childbirth diagnosis, prior uterine scar), duration and timing of the surgery, bleeding and post-operative analgesic use (R2=0.444, p<0.001). No difference was detected in the length of hospital stay, or patient satisfaction. Limiting the duration of urinary catheter therapy is associated with shorter time to post-operative mobilization. A prospective randomized trial would provide more detailed information.

Comparison of Early Versus Late Foley Catheter Removal after TURP- Our Experience

Objective: To compare early versus late catheter removal after Transurethral resection of prostate for benign prostatic hyperplasia in terms of postoperative complications. Study Design: Cross sectional Study. Place and Duration of Study: Urology Department, Armed Forces Institute of Urology, Rawalpindi Pakistan from Jan 2022 to Aug 2022. Methodology: A total of 100 patients undergoing monopolar Transurethral resection of prostate fulfilling the inclusion criteria were included in study after written informed consent. They were randomized in two equal Groups (50 patients each) by lottery method, Group A-catheter removed on day 2 and Group B-catheter removed on day 5, postoperative complications including urinary retention, hematuria, urinary tract infection and urethral stricture were recorded on proforma. Results: Both Groups had no statistically difference in demographic profile. In Group-A, 4(8%) patients had urinary retention and in Group-B, 3(6%) patients had urinary retention (p-value 0.438). The number of patients that had UTI in Group A and Group B were 1(2%) and 7(14%) respectively which was statistically significant (p&lt;0.001). However, hematuria, urethral stricture and epididymo-orchitis were not statistically significant among Groups with p-values of 1.00, 0.24 and 0.36 respectively. Conclusion: Early catheter removal after Transurethral resection of prostate resulted in decreased urinary tract infection rate as compared to delayed catheter removal without any other significant postoperative complications.

Implementation of enhanced recovery protocols in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for metastatic ovarian cancer following neoadjuvant chemotherapy. A feasibility study

ObjectiveThe aim of this study is to evaluate the implementation of the elements of enhanced recovery (ERAS) protocols in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for metastatic ovarian cancer. ERAS protocols have shown improvement in the perioperative outcomes of patients who underwent cytoreductive surgery for metastatic ovarian cancer by reducing the length of stay as well as the postoperative complications and by improving patients’ postoperative experience. MethodsThis is a feasibility study involving retrospective analysis from (31) patients who underwent cytoreductive surgery and HIPEC versus (35) a control group that underwent cytoreductive surgery only, prior to the introduction of the HIPEC programme for metastatic ovarian cancer. All patients had undergone neoadjuvant chemotherapy prior to surgery. We compared the compliance for each element of the ERAS protocol between the two study groups. ResultsWe analyzed data from 66 patients, 31 in HIPEC group and 35 in the control goup. We found no significant difference in the patients’ characteristics between the two groups and there were no differences in the implementation of 8 elements of the ERAS protocols (100 % for both groups). The use of nasogastric tube was more frequently observed in patients undergoing surgery and HIPEC compared to those undergoing surgery alone (42 % vs 0 %, respectively; p < 0.001). The number of patients who were mobilized on the first postoperative day was higher in the group undergoing surgery and HIPEC (87.1 % vs 57.1 %, respectively; p = 0.007), however there was no significant difference in the percentage of patients that had early removal of the urinary catheter (p = 0.12), nor in the percentage of patients that received early feeding (p = 0.18). Finally, there were no statistically significant differences in the complication rates, the length of hospital stay and the re-admission rates between the two groups. ConclusionEnhanced recovery protocols can be implemented safely in patients undergoing cytoreductive surgery and HIPEC for ovarian cancer.

Four-Year Study on Subcutaneous Port Catheters in Oncology Patients: Patency, Complications, and Outcomes

In this extensive four-year study, we examined subcutaneous port catheter placement in 172 oncology patients (111 men, 61 women) between March 2018 and December 2021. Our primary focus was on port patency, postoperative complications, mortality rates, and demographic factors. We excluded only one 10-month-old infant who received a pediatric port catheter. Patients predominantly underwent jugular intervention via the right internal jugular vein (97%) and occasionally the left (3%). On average, port patency lasted for 375 days, with an overall duration of 432 days. Males had a mean patency of 13.58 months, while females averaged 11.97 months. Notably, bladder cancer patients had the longest port patency (44 months), followed by uterine cancer (35 months) and breast cancer (22.5 months). Among 171 patients, nine had mild to moderate infections, six had mild ecchymosis-hematoma, and two required early catheter removal due to severe infections. Fortunately, only one patient had a mild pneumothorax not necessitating surgery. Importantly, no major complications such as hemothorax, nerve injury, neck compression, massive hematoma, blood transfusion, substantial bleeding, port detachment, rupture, or fragment embolism were recorded. Subcutaneous port catheter placement proved safe and effective for chemotherapy patients, particularly with skilled surgical teams. Procedures via the right internal jugular vein consistently yielded favorable outcomes with low infection rates, minimal occlusion, stenosis, thrombosis, and complication rates, while maintaining extended port patency. This research underscores the substantial improvement in oncology patients' quality of life by eliminating challenges associated with frequent peripheral vessel access.

Safety and benefits of early urethral catheter removal after resectioning the recto urethral fistula during posterior sagittal anorectoplasty

Aims: A urethral catheter must be placed before PSARP (Posterior Sagittal Anorectoplasty) is performed on boys with recto-urethral fistula. However, there is no agreement on when the catheter should be removed. Surgeons usually keep the catheter for more than weeks, which is uncomfortable for patients. This study assesses the advantages and safety of removing the catheter early after PSARP. Methods: We have divided the patents into two groups. In Group 1, patients underwent PSARP with resection of RUF from January 2017 to February 2021, and the urethral catheter was kept for 14 days. In Group 2, patients were operated on between March 2021 and July 2023, and the urethral catheter was removed on the second day after the operation. The two groups ' demographic and clinical variables were compared using SPSS version 26. Outcome variables were post-operative urinary retention, difficulty in micturition, catheter blockage or dislodgement, fistula recurrence, hospital stay duration, and antibiotic therapy duration. Results: No patients in either group had urinary retention, recurrence of fistula, or lower urinary complication. However, postoperative hospital stay and antibiotic therapy significantly reduced from 11.2±2.3 days in Group 1 to 4.1±0.5 days in Group 2 (p&lt;0.01). Conclusion: Early catheter removal after PSARP is safe, improves patient comfort, and reduces unnecessary hospital stays and antibiotic therapy.

Optimal timing of urinary catheter removal after cesarean section; Randomized controlled trial

Background: Urethral catheterization plays a major role for reducing the likelihood of bladder damage and avoiding urinary retention before and after cesarean section, we aim to investigate the optimal time of removal catheter after cesarean section. Material And Method: A total of 250 eligible women, who were eligible for either primary or repeat elective cesarean section, were randomly assigned to two equal groups in a prospective randomized controlled study. In group A, the catheter was removed two hours after the surgery, whereas in group B, the catheter was extracted after 12 hours. Result: our study found that group of early catheter removal (2h) associated with lower events than delayed catheter removal (12h), early catheter removal (2h) associated with less bacteriuria, urinary retention, urgency, dysuria, burning on micturition and urinary frequency. We also found that early catheter removal (2h) over delayed catheter removal (12h) in postoperative outcomes as Postoperative mobilization, Postoperative oral rehydration, First postoperative voiding and Hospital stays. Conclusion: Early removal of the catheter is associated with less bacteriuria, urinary retention, urgency, dysuria, burning on micturition, and urinary frequency and did not enhance the urinary tract infection.

Implementation of modified enhanced recovery after surgery (ERAS) following surgery for abdominal trauma; Assessment of feasibility and outcomes: A randomized controlled trial (RCT)

BackgroundEnhanced recovery after surgery(ERAS) is a set of multiple perioperative care component not a rigid protocol with improved outcomes for elective surgeries. This study aimed to assess the feasibility and outcomes in trauma patients undergoing laparotomy. Study designProspective single-centre randomized controlled trial(RCT). Patients undergoing emergency laparotomy following trauma were randomized into ERAS(early removal of catheters, early mobilization and initiation of diet, use of opioid-sparing multimodal analgesia) and conventional care groups 24 ​h post-surgery. Outcome measures included length of hospitalization(LOH), recovery of bowel function, duration of removal of catheters and 30-day complications(Clavien-Dindo). ResultsFifty patients were randomized into ERAS(n ​= ​25) and conventional care(n ​= ​25) groups. Ninety-two percent of patients were young males, 58 ​% had blunt trauma to the abdomen and the most common indication of surgery was hollow viscus injury(88 ​%). ERAS group had a reduced median LOH(days) (6 versus 8, p ​= ​0.007), early recovery of bowel function(p ​= ​0.010) and shorter times for nasogastric tube(p ​= ​0.001), urinary catheter(p ​= ​0.007) and drain(p ​= ​0.006) removal. The complications were comparable in both groups except for deep surgical site infection[significantly lower in ERAS group(p ​= ​0.009)]. ConclusionERAS is safe and significantly reduces LOH in select trauma patients undergoing laparotomy.

Appropriate timing for the removal of urinary catheters in gastrointestinal surgery with epidural anesthesia: a randomized controlled trial.

The purpose of this randomized controlled trial was to evaluate whether early urinary catheter removal is feasible during epidural anesthesia during gastrointestinal surgery in male patients at high risk for urinary retention. Male patients who underwent radical surgery for gastric or colon cancer were enrolled in this randomized controlled trial. Patients were randomized 1:1 into 2 groups: the early group, in which the urinary catheter was removed before removal of the epidural catheter on the second or third postoperative day, and the late group, in which the urinary catheter was removed after removal of the epidural catheter. The randomization adjustment factors were age (≥ 65 or < 65 years) and operative site (gastric or colon). The primary endpoint was urinary retention. The secondary endpoints were the incidence of urinary tract infection and length of postoperative hospital stay. Seventy-three patients were enrolled between March 2020 and February 2024 and assigned to the Early (n = 37) and Late (n = 36) groups. Four patients withdrew their consent after randomization. The intention-to-treat analysis showed that urinary retention occurred in 4 patients (11.1%) in the early group and 1 patient (3.0%) in the late group (P = 0.20). Urinary tract infection occurred in 1 patient (3.0%) in the late group. The median postoperative hospital stay was 9 days in both groups. Early urinary catheter removal in male patients undergoing gastrointestinal surgery with epidural anesthesia could increase urinary retention within the expected acceptable range. UMIN000040468, Date of registration: May 21, 2020.

Effect of Early Removal of Urinary Catheter in Patients Undergoing Abdominal and Thoracic Surgeries with Continuous Thoracic Epidural Analgesia on Postoperative Urinary Retention

Background: Postoperative continuous thoracic epidural analgesia (TEA) is an integral aspect of pain management after major abdominal and thoracic surgery. Under TEA, postoperative urinary retention (POUR) is frequently noted, prompting a common practice of maintaining the transurethral catheter (UC) until the cessation of TEA to avoid the necessity for reinsertion of the UC. This study analyzes the effect of an early bladder catheter removal during TEA on POUR incidence. Methods: The retrospective study was conducted on 71 patients undergoing elective abdominal and thoracic operations with TEA for postoperative pain control. Patients were divided into two groups based on the UC removal time in relation to the epidural catheter removal. In the early removal group (ERG), the UC was removed within 3 days of surgery, while in the standard group (SG), it was removed after completion of TEA. All patients in the ERG were still receiving TEA at the time of the UC removal. The primary outcome assessed was the incidence of POUR, while secondary outcomes included urinary tract infections (UTI), hospital length of stay (LOS), and patient’s comfort. Results: The overall prevalence of POUR was 7%, with five POUR cases – two (4.9%) of 41 patients in SG and three (10%) of 30 in ERG (p = 0.644). No significant difference was found in POUR occurrence between ERG and SG (p = 0.644). Additionally, no UTIs were observed in the study. The postoperative pain scores (visual analog scale [VAS]) 72 h and 96 h and the LOS (SG: 16.74 [±8.39] days; ERG: 14.53 [±6.99] days; p = 0.3) were similar between both study groups. Conclusion: Based on our results, it can be concluded that the removal of UC in the early postoperative period, even during TEA, can be performed safely without significantly increasing the risk of recatheterization.

Comparison of early and late removal of the urinary catheter after rectal cancer surgery

Comparison of early and late removal of the urinary catheter after rectal cancer surgery

Incidence of and Risk Factors for Post-Operative Urinary Retention Following Surgery for Perineal Tears Among Ugandan Women: A Prospective Cohort Study

Introduction and HypothesisWe aimed to determine the incidence and risk factors for post-operative urinary retention (POUR) following surgery for perineal tears, and to determine the time to normal voiding after POUR.MethodsThis was a prospective cohort study of women who underwent surgery for old (≥ 3 months) obstetric perineal tears from January 2022 to December 2023. The diagnosis of POUR was made in a woman who completely failed to void despite a full bladder or, one who had post-void residual (PVR) > 150 ml within 10 min of voiding. Return to normal voiding was considered if a patient with POUR had two consecutive PVRs of ≤ 150 ml. Descriptive analyses and multivariable logistic regression were performed to determine risk factors for POUR.ResultsA total of 153 participants were enrolled in this study with a mean age of 35.9 (SD ± 10.8) years. The incidence of POUR was 19.6% (30/153, 95% CI 14.02–26.7), and the median time to normal voiding for these patients was 42.4 h (range 24–72). Risk factors for POUR included repeat perineal tear surgery (RR = 4.24; 95% CI 1.16–15.52; p = 0.029) and early urinary catheter removal (RR = 2.89; 95% CI 1.09–7.67; p = 0.033).ConclusionPost-operative urinary retention following surgery for perineal tears is common. The time to return to normal voiding in patients with POUR is short. Women having repeat perineal tear surgery and those in whom the urinary catheter is removed early were more likely to experience POUR. Delayed urinary catheter removal could be considered, especially in patients undergoing repeat perineal tear surgery.

Postoperative urinary retention following transanal versus laparoscopic total mesorectal excision for rectal cancer: A randomized trial report from an experienced center

BackgroundTransanal total mesorectal excision has emerged as a potential solution to certain limitations associated with laparoscopic total mesorectal excision in rectal cancer patients. Differences in surgical approaches have raised questions regarding their impact on the risk of postoperative urinary retention, with limited data available from large scale randomized clinical study. ObjectiveTo report incidence of postoperative urinary retention and evaluate the associated risk factors for transanal total mesorectal excision. DesignIn this randomized controlled trial (ClinicalTrials. gov NCT06147492), we retrieved 524 patients who received total mesorectal excision (TME) for stage I–III rectal cancer between June 2019 and April 2022, and the patients were randomly assigned in a 1:1 ratio to undergo either taTME or laTME. PatientsWe enrolled 524 patients who underwent total mesorectal excision for stage I–III rectal cancer between June 2019 and April 2022. Main outcome measuresThe incidence of postoperative urinary retention. ResultsAmong the 524 enrolled patients, 261 were randomized to the laTME group, while 263 were were randomized the taTME group. The median age was 58 years, and 340 participants (64.8 %) were male. Notably, 37 individuals (7.0 %) experienced postoperative urinary retention during the follow-up period, with no significant disparity was observed between the taTME and laTME groups (6.8 % and 7.2 %, respectively, P = 0.98). Risk factors associated with PUR in patients following taTME encompassed early removal of the urinary catheter (P = 0.006), net infusion rate >4.09 ml kg−1.h−1 (P = 0.006), and an age surpassing 65 years (P = 0.0321). LimitationsThe generalizability of the findings outside specialist rectal cancer centers may be limited. ConclusionsTransanal total mesorectal excision was not found to heighten the risk of postoperative urinary retention. Nonetheless, it is advisable removing postoperative catheter beyond the initial day and exercising caution in the administration of intravenous fluids in clinical practice for taTME procedures.

Efficacy and feasibility of enhanced recovery after open renal surgery in Cairo University Hospital: a cohort study

Aim This study aimed to assess the efficacy of enhanced recovery after surgery (ERAS) regarding the reduction of length of hospital stay, incidence of complications, and readmission rate in patients undergoing open renal surgery. Settings and design This cohort study was conducted at the theater for urological surgeries at the Cairo University Teaching Hospital. Patients and methods The patients received general anesthesia using the standard center preferences. General anesthesia was supplemented by regional anesthesia in the form of erector spinae plane block (ESPB). Then patients were awakened using the ERAS protocol. Sixty-five adult patients (aged 18–60 years) of both sexes who were scheduled for open renal surgery under general anesthesia were included in the study. Patients with an American Association of Anesthesiologists physical status I or II were eligible. The visual analog scale (VAS) was used to assess the level of pain helping rapid recovery of all patients. Patients received ESPB after general anesthesia. Proper analgesia was assessed and evaluated to help patients with rapid ambulation and recovery. Days of hospital stay and postoperative pain were measured using the VAS score at specific intervals. In addition, the number of daily opioid doses administered, time to ambulation, time of indwelling nephrostomy tube and urethral catheter, and incidence of complications (secondary hemorrhage) were recorded. Results During our ERAS plan supplementing general anesthesia with ESPB in patients scheduled for open renal surgeries, VAS scores were significantly low which did not need extra analgesics in most cases, and the daily doses of nalbuphine required were significantly decreased. Early ambulation has shown a great improvement with a shorter hospital stay and early removal of drains and catheters with a lower incidence of complications. Conclusions ERAS is a multimodal approach to perioperative care that can be applied to any type of surgery, and it has been shown to improve patient recovery, reduce complications, enhance patient satisfaction, and lower hospitalization costs following open renal surgeries.

Evaluating the effectiveness of early urethral catheter removal combined with intermittent catheterization for promoting early recovery of bladder function after laparoscopic radical hysterectomy: a study protocol for a randomized controlled trial

BackgroundBladder dysfunction, notably urinary retention, emerges as a significant complication for cervical cancer patients following radical hysterectomy, predominantly due to nerve damage, severely impacting their postoperative quality of life. The challenges to recovery include insufficient pelvic floor muscle training and the negative effects of prolonged postoperative indwelling urinary catheters. Intermittent catheterization represents the gold standard for neurogenic bladder management, facilitating bladder training, which is an important behavioral therapy aiming to enhance bladder function through the training of the external urethral sphincter and promoting the recovery of the micturition reflex. Nevertheless, gaps remain in current research regarding optimal timing for intermittent catheterization and the evaluation of subjective symptoms of bladder dysfunction.MethodsCervical cancer patients undergoing laparoscopic radical hysterectomy will be recruited to this randomized controlled trial. Participants will be randomly assigned to either early postoperative catheter removal combined with intermittent catheterization group or a control group receiving standard care with indwelling urinary catheters. All these patients will be followed for 3 months after surgery. The study’s primary endpoint is the comparison of bladder function recovery rates (defined as achieving a Bladder Function Recovery Grade of II or higher) 2 weeks post-surgery. Secondary endpoints include the incidence of urinary tract infections, and changes in urodynamic parameters, and Mesure Du Handicap Urinaire scores within 1 month postoperatively. All analysis will adhere to the intention-to-treat principle.DiscussionThe findings from this trial are expected to refine clinical management strategies for enhancing postoperative recovery among cervical cancer patients undergoing radical hysterectomy. By providing robust evidence, this study aims to support patients and their families in informed decision-making regarding postoperative bladder management, potentially reducing the incidence of urinary complications and improving overall quality of life post-surgery.Trial registrationChiCTR2200064041, registered on 24th September, 2022.