A randomized controlled trial of clean intermittent self-catheterization versus suprapubic catheterization after urogynecologic surgery

• Published in: American journal of obstetrics and gynecology Vol. 197; no. 1; pp. 72.e1 - 72.e4
• Main Authors: Jannelli, Mary L., MD, Wu, Jennifer M., MD, Plunkett, Linda W., MSN, Williams, Kathryn S., BS, Visco, Anthony G., MD
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01-07-2007
• Subjects: Adult; Aged; Bacteriuria - etiology; clean intermittent self-catheterization; Female; Humans; Middle Aged; Obstetrics and Gynecology; Patient Satisfaction; postoperative bladder drainage; Risk Factors; Self Care; significant bacteruria; suprapubic catheterization; Time Factors; Urinary Catheterization - adverse effects; Urinary Catheterization - methods; Urogenital Surgical Procedures; postoperative bladder drainage; suprapubic catheterization; clean intermittent self-catheterization; significant bacteruria
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2007.02.043

Objective The purpose of this study was to compare the risk of significant bacteruria between clean intermittent self-catheterization (CISC) and suprapubic catheterization (SPC) after urogynecologic surgery. Study Design Patients were randomized to CISC or SPC. A urinalysis and patient satisfaction questionnaire were conducted on postoperative days 2 and 7. Urine culture was performed for positive urinalysis. Significant bacteruria was defined as > 100,000 cfu/mL. To detect a decrease in bacteruria risk from 25% to 10%, 113 subjects per group were needed with 80% power and α of 0.05. Results Of 248 randomized patients, 210 were included in the final analysis. The overall risk of bacteruria was 27% with no difference between SPC and CISC (31% vs 23%, P = .23). Patients reported more frustration ( P = .01) and more difficulty ( P = .003) using CISC. Conclusion There was no difference in risk of significant bacteruria between CISC and SPC. Patients reported more frustration and difficulty with self-catheterization.