Aslam Muhammad Faisal, Bazzi Ali A, Hagglund Karen H, Osmundsen Blake C
From the Department of Obstetrics and Gynecology at St. John Hospital and Medical Center, Detroit, MI.
Division of Organology and Reconstructive Pelvic Surgery, Legacy Health, Portland, OR.
Female Pelvic Med Reconstr Surg. 2020 Feb;26(2):120-127. doi: 10.1097/SPV.0000000000000826.
The aim of the study was to determine the best practice guidelines regarding the use of indwelling catheters after minimally invasive sacrocolpopexy.
Multicenter (3 sites) randomized control trial comparing the standard overnight indwelling urethral catheterization (group 2) with removal of catheter immediately after surgery (group 1). Our primary outcome is the need for recatheterization. Secondary outcomes include the number of patients discharged with a catheter, length of hospital stay, number of urinary tract infections, patient satisfaction/pain scores, and whether patients would use the same treatment again.
There were 32 patients (43.8%) in group 1 and 41 patients (56.2%) in group 2. On average, patients in group 1 required straight catheterization 0.8 (SD = 0.9) times versus 0.6 (SD = 0.9) times for group 2 (P = 0.239). The number of days with a catheter between the 2 groups was not statistically significant. There was no statistical significance between group 1 and group 2 in terms of operative time, times to leave the operating room, and hospital. Zero patients in group 1 and 2 patients in group 2 had a urinary tract infection. After dividing the groups based on whether or not they underwent a transvaginal tape procedure, the final results were similar.
We did not observe a difference in the risk of recatheterization or discharge home with a urinary catheter between the 2 groups. Addition of transvaginal tape to sacrocolpopexy did not show a difference in the risk of recatheterization. One reason for the lack of difference between the 2 groups could be due to a lack of power in our study.
本研究旨在确定微创骶骨阴道固定术后留置导尿管的最佳实践指南。
多中心（3个地点）随机对照试验，比较标准的过夜留置尿道导尿（第2组）与术后立即拔除导尿管（第1组）。我们的主要结局是再次导尿的需求。次要结局包括带导尿管出院的患者数量、住院时间、尿路感染数量、患者满意度/疼痛评分，以及患者是否会再次接受相同治疗。
第1组有32例患者（43.8%），第2组有41例患者（56.2%）。平均而言，第1组患者需要直接导尿0.8（标准差=0.9）次，而第2组为0.6（标准差=0.9）次（P=0.239）。两组之间带导尿管的天数无统计学意义。第1组和第2组在手术时间、离开手术室时间和住院时间方面无统计学意义。第1组0例患者和第2组2例患者发生尿路感染。根据是否进行经阴道尿道中段吊带术对两组进行划分后，最终结果相似。
我们未观察到两组之间再次导尿风险或带导尿管出院风险存在差异。在骶骨阴道固定术中增加经阴道尿道中段吊带术在再次导尿风险方面未显示出差异。两组之间缺乏差异的一个原因可能是我们的研究样本量不足。
