Asian Journal of Surgery
Volume 33, Issue 1 , Pages 31-36, January 2010

Is Transurethral Catheterisation the Ideal Method of Bladder Drainage? A Survey of Patient Satisfaction With Indwelling Transurethral Urinary Catheters

  • Siew Pang Chan

      Affiliations

    • School of Business, Singapore Institute of Management University, Singapore
  • Glenn Wei Leong Tan

      Affiliations

    • Corresponding Author InformationAddress correspondence and reprint requests to Glenn Wei Leong Tan, Clinical Staff Office 4B, Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433
  • ,
  • Choon Kiat Ho

Department of General Surgery, Tan Tock Seng Hospital, Singapore

Accepted 11 February 2010.

Article Outline

Objective

Bladder catheterisation is a routine part of major abdominal surgery. Transurethral catheterisation is the most common method of bladder drainage but is also notorious for its discomfort and increased risk of urinary tract infection. The present study aimed to establish patient satisfaction with transurethral catheterisation and to assess the incidence of clinically significant urinary tract infections after transurethral catheterisation through survey.

Methods

All patients who underwent major open abdominal surgery between October 2006 and December 2008 and required standard transurethral bladder catheterisation, were asked to participate in the study. Fifty patients were recruited.

Results

Male patients were more dissatisfied than their female counterparts with transurethral catheterisation (satisfaction score: 4.18/10 vs. 2.75/10; p = 0.05). Male patients had more than double the score for pain at the urinary meatus with the catheter in situ (p =0.012) and during urine catheter removal (p = 0.013). Half the patients in the study also had symptoms of urinary tract infection after catheter removal.

Conclusion

Our study emphasised the discomfort of transurethral urinary catheters, especially in male patients, and the high incidence of urinary tract infections in both sexes. Consideration should be given to the utilisation of alternative methods of bladder drainage, such as suprapubic catheterisation, which can be performed with ease during laparotomy.

Key Words:  bladder drainage , transurethral catheterisation , urinary tract infection

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Stark RP , Maki DG . Bacteriuria in the catheterized patient. What quantitative level of bacteriuria is relevant? . N Engl J Med . 1984;311:560–564
  2. Buchholz NP , Riehmann M , Gasser TC . Absence of urethral strictures with suprapubic urinary drainage during extracorporeal circulation . J Urol . 1993;150:337–339
  3. Baan AH , Vermeulen H , van der Meulen J , et al.   The effect of suprapubic catheterization versus transurethral catheterization after abdominal surgery on urinary tract infection: a randomized controlled trial . Dig Surg . 2003;20:290–295
  4. Branagan GW , Moran BJ . Published evidence favours the use of suprapubic catheters in pelvic colorectal surgery . Dis Colon Rectum . 2002;45:1104–1108
  5. McPhail MJW , Abu-Hilal A , Johnson CD . A meta-analysis comparing suprapubic and transurethral catheterization for bladder drainage after abdominal surgery . Br J Surg . 2006;93:1038–1044
  6. Perrin LC , Penfold C , McLeish A . A prospective randomized controlled trial comparing suprapubic with urethral catheterization in rectal surgery . Aust N Z J Surg . 1997;67:554–556
  7. O'Kelly TJ , Matthew A , Ross S , et al.   Optimum method for urinary drainage in major abdominal surgery: a prospective randomized trial of suprapubic versus urethral catheterization . Br J Surg . 1995;82:1367–1368
  8. Sethia KK , Selkon JB , Berry AR , et al.   Prospective randomized controlled trial of urethral versus suprapubic catheterization . Br J Surg . 1987;74:624–625
  9. Bostios D , Demetriades C , Goulimaris I , et al.   Suprapubic percutaneous cystostomy versus urethral catheterization in abdominal surgery . Dig Surg . 2003;20:290–295
  10. Niël-Weise BS , van den Broek PJ . Urinary catheter policies for short-term bladder drainage in adults . Cochrane Database Syst Rev . 2005;3: CD004203
  11. Tambyah PA , Maki DG . Catheter-associated urinary tract infection is rarely symptomatic: a prospective study of 1497 catheterized patients . Arch Intern Med . 2000;160:678–682
  12. Platt R , Polk F , Murdock B , et al.   Mortality associated with nosocomial urinary tract infections . N Engl J Med . 1982;307:637–641
  13. Johnson CD . Suprapubic catheterization at laparotomy . Dig Surg . 2006;23:281–282
  14. Eikenberg H , Amin M , Klompus W , et al.   Urological complications following abdominoperineal resection . J Urol . 1976;115:180–182

PII: S1015-9584(10)60006-1

doi:10.1016/S1015-9584(10)60006-1

Asian Journal of Surgery
Volume 33, Issue 1 , Pages 31-36, January 2010