Effectiveness of foley catheter usage time in prevention of urinary fistula in laparoscopic hysterectomy
Abstract
Aim: This study aimed to investigate the relationship between Foley catheter retention time and the incidence of urinary fistula in patients undergoing laparoscopic hysterectomy.
Materials and Methods: The present retrospective study included a total of 312 patients who underwent laparoscopic hysterectomy for benign indications between the years 2015 and 2023. The patients were divided into two main groups according to the duration of Foley catheter use following surgery:
The duration of Foley catheter use was categorized as less than three days or more than seven days. The data were subjected to comparison between the two groups, with the objective of analyzing the impact of catheter use duration on the development of postoperative urinary fistulae.
Results: A postoperative urinary fistula was observed in 13 patients (4.2%) of the 312 individuals who underwent laparoscopic hysterectomy. The rate of erythrocyte suspension (ES) transfusion was significantly higher in the group with postoperative urinary fistula (38.5%). The duration of Foley catheter use was significantly shorter in patients with a postoperative urinary fistula. The results of the logistic regression analysis indicated that a longer duration of Foley catheterization was associated with a reduced risk of fistula development (OR=0.100, 95% CI: 0.012-0.797, p=0.030).
Conclusion: This study demonstrates that long-term Foley catheter use after laparoscopic hysterectomy significantly reduces the risk of fistula development. The findings suggest that careful management of the duration of catheter use in the postoperative period may play an important role in preventing serious complications such as fistula.
References
- Pickett CM, Seeratan DD, Mol BWJ, Nieboer TE, Johnson N, Bonestroo T, vd. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 2023;8(8).
- Vikram S, Om Kumar Y, Arjun Singh S, Mahendra S, Deepak Prakash B, Shashank T, vd. Genitourinary Fistula: epidemiology, changing trends in etiology and management: A tertiary care institute’s perspective. Urologia 2024;91(2):243-8.
- Ardiansyah E, Lubis AT, Syahputra MI. Prolonged Indwelling Foley Catheter Use in Post-operative Gynecology Patient Associated with an Increased Incidence of Urinary Tract Infections. Open Access Maced J Med Sci 2021;9(3):258-61.
- Smorgick N, DeLancey J, Patzkowsky K, Advincula A, Song A, As-Sanie S. Risk Factors for Postoperative Urinary Retention After Laparoscopic and Robotic Hysterectomy for Benign Indications. Obstet Gynecol 2012;120(3):581.
- Punjani N, Winick-Ng J, Welk B. Postoperative Urinary Retention and Urinary Tract Infections Predict Midurethral Sling Mesh Complications. Urology 2017;(99):42-8.
- Carden A, Kitamura RK, Leppert J, Eisenberg D. Early Removal of Foley Catheter after Sigmoid Colectomy for Diverticular Colovesical Fistula without Intraoperative Bladder Repair or Post-operative Cystography: Feasibility of a Quality Improvement Pilot Program. Int J Surg Res Pr 2019;(6):095.
- Hafsi M, Moussi M, Zouaghi A, Najar S, Dridi F, Maroua S, Mourali M. Vesicovaginal fistula post-vaginal delivery late revelation: A case report. Edorium J Gynecol Obstet 2024;9(1):1–4.
- Wang Z, Qin Y, Yang C, Wei X, Qian J, Tu S, Yao J. Conservative treatment of urinary fistula: Case report. Exp Ther Med 2022;6(2):491.
- Xu L, Tao ZY, Lu JY, Zhang GN, Qiu HZ, Wu B, Lin GL, Xu T, Xiao Y. A single-center, prospective, randomized clinical trial to investigate the optimal removal time of the urinary catheter after laparoscopic anterior resection of the rectum: study protocol for a randomized controlled trial. Trials 2019;15(1):133.
- Lee, SY, Kang, SB, Kim, DW, Oh HK, Ihn MH. Risk Factors and Preventive Measures for Acute Urinary Retention after Rectal Cancer Surgery. World J Surg [05 Sep 2015]. Avaible from: https://link.springer.com/article/10.1007/s00268-014-2767-9.
- Stapler SJ, Colom SM, Rajkumar D, Cleary RK. Early Urinary Catheter Removal After Colectomy for Colovesical Fistula is Not Associated With Increased Postoperative Complications. Am Surg 2023;89(12):6091-7.
- Kumar A, Ram Dhayal I. A Comparative Study on the Outcomes of Hypospadias Surgery Following Early Versus Late Bladder Catheter Removal. Cureus. 2022;20;(6):e26104.
- Gabra A, Beyari BM, AlNuwaiser SJ, Allaf SM, Alghanmi R, Alrayiqi R, Mosaad F, Kurdi M. Outcomes of Hypospadias Repair Based on Surgical Techniques: A 4-Year Retrospective Study. Res Rep Urol 2024;27(16):79-87.
- Berglund DD, Parker DM, Fluck M, Dove J, Falvo A, Horsley RD, Gabrielsen J, Petrick AT, Daouadi M. Impact of Urinary Catheterization on Postoperative Outcomes After Roux-En-Y Gastric Bypass Surgery in Propensity-Matched Cohorts. Am Surg 2023;89(2):280-5.
- Meddings J, Skolarus TA, Fowler KE, Bernstein SJ, Dimick JB, Mann JD, Saint S. Michigan Appropriate Perioperative (MAP) criteria for urinary catheter use in common general and orthopaedic surgeries: results obtained using the RAND/UCLA Appropriateness Method. BMJ Qual Saf 2019;28(1):56-66.
- Li Y, Meador KJ. Epilepsy and Pregnancy. Continuum (Minneap Minn) 2022;28(1):34-54.
Abstract
Amaç: Bu çalışma, laparoskopik histerektomi geçiren hastalarda Foley kateterin tutulma süresi ile üriner fistül insidansı arasındaki ilişkiyi araştırmayı amaçlamıştır.
Gereç ve Yöntem: Bu retrospektif çalışma, 2015 ile 2023 yılları arasında benign nedenlerle laparoskopik histerektomi uygulanan toplam 312 hastayı içermektedir. Hastalar, ameliyat sonrası Foley kateter kullanım süresine göre iki ana gruba ayrılmıştır: Kateter kullanım süresi üç günden az veya yedi günden fazla olarak kategorize edilmiştir. Bu veriler iki grup arasında karşılaştırılmış ve kateter kullanım süresinin postoperatif üriner fistül gelişimi üzerindeki etkisi analiz edilmiştir.
Bulgular: Laparoskopik histerektomi uygulanan 312 bireyin 13'ünde (%4,2) postoperatif üriner fistül gözlenmiştir. Postoperatif üriner fistülü olan grupta eritrosit süspansiyonu (ES) transfüzyon oranı, fistülü olmayan gruba göre önemli ölçüde daha yüksekti (%38,5'e karşı %17,1, p=0,049). Foley kateter kullanım süresi, postoperatif üriner fistülü olan hastalarda önemli ölçüde daha kısadır. Lojistik regresyon analizi sonuçları, uzun süreli Foley kateterizasyonunun fistül gelişim riskini azalttığını göstermiştir (OR=0,100, GA: 0,012-0,797, p=0,030).
Sonuç: Bu çalışma, laparoskopik histerektomi sonrası uzun süreli Foley kateter kullanımının fistül gelişim riskini önemli ölçüde azalttığını göstermektedir. Bulgular, postoperatif dönemde kateter kullanım süresinin ciddi komplikasyonlar gibi fistül önlemede önemli bir rol oynayabileceğini öne sürmektedir
References
- Pickett CM, Seeratan DD, Mol BWJ, Nieboer TE, Johnson N, Bonestroo T, vd. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 2023;8(8).
- Vikram S, Om Kumar Y, Arjun Singh S, Mahendra S, Deepak Prakash B, Shashank T, vd. Genitourinary Fistula: epidemiology, changing trends in etiology and management: A tertiary care institute’s perspective. Urologia 2024;91(2):243-8.
- Ardiansyah E, Lubis AT, Syahputra MI. Prolonged Indwelling Foley Catheter Use in Post-operative Gynecology Patient Associated with an Increased Incidence of Urinary Tract Infections. Open Access Maced J Med Sci 2021;9(3):258-61.
- Smorgick N, DeLancey J, Patzkowsky K, Advincula A, Song A, As-Sanie S. Risk Factors for Postoperative Urinary Retention After Laparoscopic and Robotic Hysterectomy for Benign Indications. Obstet Gynecol 2012;120(3):581.
- Punjani N, Winick-Ng J, Welk B. Postoperative Urinary Retention and Urinary Tract Infections Predict Midurethral Sling Mesh Complications. Urology 2017;(99):42-8.
- Carden A, Kitamura RK, Leppert J, Eisenberg D. Early Removal of Foley Catheter after Sigmoid Colectomy for Diverticular Colovesical Fistula without Intraoperative Bladder Repair or Post-operative Cystography: Feasibility of a Quality Improvement Pilot Program. Int J Surg Res Pr 2019;(6):095.
- Hafsi M, Moussi M, Zouaghi A, Najar S, Dridi F, Maroua S, Mourali M. Vesicovaginal fistula post-vaginal delivery late revelation: A case report. Edorium J Gynecol Obstet 2024;9(1):1–4.
- Wang Z, Qin Y, Yang C, Wei X, Qian J, Tu S, Yao J. Conservative treatment of urinary fistula: Case report. Exp Ther Med 2022;6(2):491.
- Xu L, Tao ZY, Lu JY, Zhang GN, Qiu HZ, Wu B, Lin GL, Xu T, Xiao Y. A single-center, prospective, randomized clinical trial to investigate the optimal removal time of the urinary catheter after laparoscopic anterior resection of the rectum: study protocol for a randomized controlled trial. Trials 2019;15(1):133.
- Lee, SY, Kang, SB, Kim, DW, Oh HK, Ihn MH. Risk Factors and Preventive Measures for Acute Urinary Retention after Rectal Cancer Surgery. World J Surg [05 Sep 2015]. Avaible from: https://link.springer.com/article/10.1007/s00268-014-2767-9.
- Stapler SJ, Colom SM, Rajkumar D, Cleary RK. Early Urinary Catheter Removal After Colectomy for Colovesical Fistula is Not Associated With Increased Postoperative Complications. Am Surg 2023;89(12):6091-7.
- Kumar A, Ram Dhayal I. A Comparative Study on the Outcomes of Hypospadias Surgery Following Early Versus Late Bladder Catheter Removal. Cureus. 2022;20;(6):e26104.
- Gabra A, Beyari BM, AlNuwaiser SJ, Allaf SM, Alghanmi R, Alrayiqi R, Mosaad F, Kurdi M. Outcomes of Hypospadias Repair Based on Surgical Techniques: A 4-Year Retrospective Study. Res Rep Urol 2024;27(16):79-87.
- Berglund DD, Parker DM, Fluck M, Dove J, Falvo A, Horsley RD, Gabrielsen J, Petrick AT, Daouadi M. Impact of Urinary Catheterization on Postoperative Outcomes After Roux-En-Y Gastric Bypass Surgery in Propensity-Matched Cohorts. Am Surg 2023;89(2):280-5.
- Meddings J, Skolarus TA, Fowler KE, Bernstein SJ, Dimick JB, Mann JD, Saint S. Michigan Appropriate Perioperative (MAP) criteria for urinary catheter use in common general and orthopaedic surgeries: results obtained using the RAND/UCLA Appropriateness Method. BMJ Qual Saf 2019;28(1):56-66.
- Li Y, Meador KJ. Epilepsy and Pregnancy. Continuum (Minneap Minn) 2022;28(1):34-54.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Obstetrics and Gynaecology |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | August 25, 2025 |
| Submission Date | February 15, 2025 |
| Acceptance Date | August 6, 2025 |
| Published in Issue | Year 2025Volume: 64 Issue: Özel Sayı: 1 (11. Ulusal Ürojinekoloji Kongresi Bildiri Kitapçığı) |
