A Cochrane review [Abstract] 1 included 39 studies with a total of 3 709 subjects undergoing gynaecological or urological procedures. Studies were generally small and of poor or moderate quality, reporting data on only few outcomes. Confidence intervals were all wide. There was a tendency to a higher risk of (re)catheterisation if a catheter was not used at all postoperatively, but estimate was imprecise of any difference in urinary tract infection (5 trials). Recatheterisation was needed for more patients if a urethral catheter rather than a suprapubic one was used (RR 3.66, 95% CI 1.41 to 9.49; 6 trials). Urinary tract infections were fewer when a catheter was removed earlier (for example 1 versus 3 days, RR 0.50, 95% CI 0.29 to 0.87; 7 trials) with no pattern in respect of catheterisation. Clamp-and-release policy before catheter removal showed a significantly greater incidence of urinary tract infections (RR 4.00, 95% 1.55 to 10.29) and a delay in return to normal voiding (RR 2.50, 95% CI 1.16 to 5.39) compared to immediate catheter removal (1 trial).
Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison) and by limitations in study quality (e.g. poor reporting, inadequate or unclear allocation concealment)
Primary/Secondary Keywords