Optimum method for urinary drainage in major abdominal surgery: A prospective randomized trial of suprapubic <i>versus</i> urethral catheterization

O'Kelly, T. J.; Mathew, Alex; Ross, Seamus; Munro, A.

doi:10.1002/bjs.1800821024

Cited by 64 publications

(26 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present study, a higher relative risk of 3.4 (95% CI = 1.4–8.0) for development of infection was found in patients with a catheter for more than 7 days, but this could also be influenced by a higher number of postoperative complications and recatheterization in this group of patients. A sex-related difference in infection rate as found in this study has been mentioned earlier [3, 4, 5, 6, 7, 8]. Sethia et al [3]did not find a difference between urethral and suprapubic catheter infection rates in men, but a significant lower infection rate in women with a suprapubic catheter.…”

Section: Discussionsupporting

confidence: 52%

See 1 more Smart Citation

The Effect of Suprapubic Catheterization versus Transurethral Catheterization after Abdominal Surgery on Urinary Tract Infection: A Randomized Controlled Trial

Baan¹,

Vermeulen²,

Meulen

et al. 2003

Dig Surg

View full text Add to dashboard Cite

Background/Aim: Transurethral catheterization is generally associated with a higher incidence of urinary tract infections than suprapubic catheterization; however, suprapubic catheterization is associated with other disadvantages such as higher costs and a more difficult technique, and at the moment there is no consensus about the use of both catheter systems. Therefore, a prospective randomized study was performed to investigate the effects of suprapubic catheterization and transurethral catheterization in patients undergoing surgery on the incidence of urinary tract infections and patient satisfaction. Methods: Patients who underwent an elective laparotomy were randomized and received a suprapubic or transurethral catheter. The primary end point was urinary tract infection. Other parameters of urinary tract infection, as well as duration of catheterization, hospital stay, and number of recatheterizations and of relaparotomies were monitored. Treatment ‘per protocol’ was also analyzed after exclusion of patients receiving another catheter than randomized for. Patients were asked for their satisfaction with the catheters and complaints during and after catheterization. Results: 165 patients were eligible, of whom 19 patients had to be excluded. 75 patients were allocated to receive the suprapubic catheter and 71 the transurethral catheter. There was no difference in the incidence of a urinary tract infection between the suprapubic group (n = 9/75; 12%) and the transurethral group (n = 8/71; 11%). Most patients (6/9) who developed a urinary tract infection in the suprapubic group, however, underwent recatheterization because of postoperative complications/sepsis and relaparotomy. The incidence of urinary tract infections in patients who received a suprapubic catheter and not a transurethral catheter was 3/59 (5%). The patients did not differ with respect to satisfaction and complaints. Being a men, recatheterization and duration of catheterization are risk factors. Conclusions: The incidence of a urinary tract infection between a suprapubic catheter and a transurethral catheter in patients undergoing major surgery was not different. A potential advantage of the suprapubic catheter (reduction of urinary tract infections) is probably partly negated, because transurethral catheters were used if recatheterization was indicated during the postoperative stay or due to complications.

show abstract

Section: Discussionsupporting

confidence: 52%

“…The disadvantages are the higher costs of the catheter and the more difficult catheterization technique which is not feasible under all circumstances. The effects of the two catheter systems on the development of urinary tract infections have only been studied in a few and relative small randomized studies with limited power [3, 4, 5, 6]. …”

Section: Introductionmentioning

confidence: 99%

The Effect of Suprapubic Catheterization versus Transurethral Catheterization after Abdominal Surgery on Urinary Tract Infection: A Randomized Controlled Trial

Baan¹,

Vermeulen²,

Meulen

et al. 2003

Dig Surg

View full text Add to dashboard Cite

show abstract

“…18,27 In our study, bladder washout represents a very high risk of ESBL infection in both univariate (p<0.001) and multivariate analysis (p<0.001). This can be explained by the manipulation of the system, the increase of the catheterization time, and the duration of hospitalization.…”

Section: Closed Drainagementioning

confidence: 55%

Nosocomial urinary tract infections caused by extended-spectrum beta-lactamase uropathogens: Prevalence, pathogens, risk factors, and strategies for infection control

Bouassida¹,

Jaidane²,

Bouallègue³

et al. 2016

CUAJ

View full text Add to dashboard Cite

Introduction: Our goal was to investigate the prevalence and antibiogram pattern of extended spectrum beta-lactamase (ESBL) production among uropathogens using isolates from urine samples collected at the Department of Urology in the Sahloul Hospital, Tunisia We also aimed to identify the risk factors for nosocomial urinary tract infections (UTIs) in patients who underwent transurethral resection of the prostate (TURP) and the measures for infection control. Methods: Laboratory records of a five-year period from January 2004 to December 2008 were submitted for retrospective analysis to determine the incidence of ESBL infections. A total of 276 isolates were collected. A case-control study involving comparisons between two groups of patients who underwent TURP was performed to determine the risk factors for ESBL infection. Group 1, designated case subjects, included 51 patients with nosocomial UTI after TURP. Group 2, designated control subjects, consisted of 58 randomly selected patients who underwent TURP without nosocomial UTI in the same period. Factors suspected to be implicated in the emergence of ESBL infection were compared between the two groups in order to identify risk factors for infection. A univariate regression analysis was performed, followed by a multivariate one. Results: The annual prevalence of ESBL infection ranged from 1.3-2.5%. After performing univariate and multivariate regression analysis, the main risk factors for ESBL infections were identified as: use of antibiotics the year preceding the admission, duration of catheter use, and bladder washout (p=0.012, p=0.019, and p<0.001. Conclusions: Urologists have to perform a good hemostasis, especially in endoscopic resections, in order to avoid bladder irrigation and bladder washout and to reduce the time of bladder catheterization, which is a strong risk factor of nosocomial UTIs. IntroductionHospital infections have become a growing healthcare challenge in recent decades and serious concerns have been expressed over the rise in antimicrobial resistance among pathogens causing hospital-acquired infections. Nosocomially acquired urinary tract infection (NAUTI) is one of the most common hospital-acquired infections. 2,3This infection is not already present or incubating at the time of admission, but is acquired during hospital stay. Its definition requires a 48-hour delay after admission before symptoms appear.1,4,5 NAUTI has become one of the most important quality parameters for urological surgery. The problem is further exacerbated by the emergence of drug resistance among uropathogens in the form of extended spectrum beta-lactamase (ESBL) production. In fact, the first outbreak of ESBL-producing organisms was reported in 1983 in Germany 1 and involved chromosomal-or plasmid-mediated beta-lactamases (enzymes that cleave the beta-lactam ring) that had mutated from pre-existing broad-spectrum beta-lactamases as a consequence of the extensive use of third-generation cephalosporins and aztreonam.6 Those ESBL-producing pathogens are now...

show abstract

“…Studies examining postoperative urinary tract infections report incidences from 4 to 60% [1,3,4,5,8,9,10,11,13,15]. Several randomized controlled trials concluded suprapubic catheters to be superior to transurethral catheters for postoperative urinary drainage in order to reduce rates of urinary tract infection [1,5,9,10,11,13].…”

Section: Discussionmentioning

confidence: 99%

“…The effects of the two catheter systems on the risk of postoperative urinary retention and increased PRVs have only been studied in a few randomized controlled trials. The majority of these trials has been performed in patients, both men and women, who underwent general abdominal surgery [8,9,10,11,12]. A small number of trials studied women after gynecological surgery, concerning procedures such as correction of stress incontinence, radical hysterectomy for cervical carcinoma and a combination of various pelvic organ prolapse surgery techniques [1,13,14].…”

Section: Discussionmentioning

confidence: 99%

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

Stekkinger¹,

Linden²

2011

Gynecol Obstet Invest

View full text Add to dashboard Cite

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.

show abstract

Optimum method for urinary drainage in major abdominal surgery: A prospective randomized trial of suprapubic versus urethral catheterization

Cited by 64 publications

References 2 publications

The Effect of Suprapubic Catheterization versus Transurethral Catheterization after Abdominal Surgery on Urinary Tract Infection: A Randomized Controlled Trial

The Effect of Suprapubic Catheterization versus Transurethral Catheterization after Abdominal Surgery on Urinary Tract Infection: A Randomized Controlled Trial

Nosocomial urinary tract infections caused by extended-spectrum beta-lactamase uropathogens: Prevalence, pathogens, risk factors, and strategies for infection control

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

Contact Info

Product

Resources

About