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Vol. 20, No. 4, 2003
Issue release date: 2003
Section title: Original Paper
Dig Surg 2003;20:290–295
(DOI:10.1159/000071693)

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

Baan A.H. · Vermeulen H. · van der Meulen J. · Bossuyt P. · Olszyna D. · Gouma D.J.
Departments of aSurgery, bInternal Medicine, and cClinical Epidemiology, Academic Medical Center, Amsterdam, The Netherlands

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 7/25/2002
Accepted: 1/1/2003
Published online: 7/8/2003

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 4

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: http://www.karger.com/DSU

Abstract

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.


  

Author Contacts

D.J. Gouma
Department of Surgery
Academic Medical Center, Meibergdreef 9
NL–1105 AZ Amsterdam (The Netherlands)
Tel. +31 20 566 2166, Fax +31 20 6914 858, E-Mail d.j.gouma@amc.uva.nl

  

Article Information

Received: July 25, 2002
Accepted: January 1, 2003
Published online: June 5, 2003
Number of Print Pages : 6
Number of Figures : 1, Number of Tables : 4, Number of References : 8

  

Publication Details

Digestive Surgery
Official Publication of the International Society for Digestive Surgery (ISDS, formerly CICD), European Digestive Surgery (EDS), Dutch Society of Gastro-Intestinal Surgery (NVGIC), Japanese Society of Gastroenterological Surgery (JSGS), Hellenic Society for Digestive Surgery (HSDS)

Vol. 20, No. 4, Year 2003 (Cover Date: 2003)

Journal Editor: M.W. Büchler, Heidelberg; J.P. Neoptolemos, Liverpool
ISSN: 0253–4886 (print), 1421–9983 (Online)

For additional information: http://www.karger.com/dsu


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 7/25/2002
Accepted: 1/1/2003
Published online: 7/8/2003

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 4

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: http://www.karger.com/DSU


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