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Bladder Care Following Benign Non-Hysterectomy Gynecological Laparoscopy: A Randomized Clinical Trial
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  • Lalla McCormack,
  • Sophia Song,
  • Aaron Budden ,
  • Christine Ma,
  • Kimberly Nguyen ,
  • Fiona Li,
  • Claire Yinn Lim,
  • Sarah Maheux-Lacroix,
  • Amy Arnold,
  • Rebecca Deans,
  • Haryun Won,
  • Blake Knapman,
  • Erin Nesbitt Hawes ,
  • Jason Abbott
Lalla McCormack
Royal Hospital for Women

Corresponding Author:[email protected]

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Sophia Song
University of New South Wales
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Aaron Budden
University of New South Wales
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Christine Ma
University of New South Wales
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Kimberly Nguyen
University of New South Wales
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Fiona Li
University of New South Wales
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Claire Yinn Lim
University of New South Wales
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Sarah Maheux-Lacroix
Université Laval
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Amy Arnold
Gynaecology Research and Clinical Evaluation Group
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Rebecca Deans
University of New South Wales
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Haryun Won
University of New South Wales
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Blake Knapman
University of New South Wales
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Erin Nesbitt Hawes
University of New South Wales
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Jason Abbott
University of New South Wales
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Abstract

Abstract Objective: To compare rates of urinary retention and postoperative urinary tract infection between women with immediate versus delayed removal of indwelling catheter following benign non-hysterectomy gynecological laparoscopic surgery. Design: This randomized clinical trial was conducted between February 2012 and December 2019, with follow-up to six weeks, in two university-affiliated hospitals in Sydney, Australia. Population: Study participants were 693 women over 18 years of age, undergoing non-hysterectomy laparoscopy for benign gynecological conditions, excluding pelvic floor or concomitant bowel surgery. Methods: 355 participants were randomized to immediate, and 338 to delayed removal of urinary catheter. Main Outcome Measures: The co-primary outcomes were urinary retention (assessed by trial of void and need to re-catheterize) and urinary tract infection. Secondary outcomes included readmission, analgesia requirements, duration of hospitalization and validated bladder function questionnaires. Results: Urinary retention for participants in the immediate removal group was statistically higher at 8.2% (95% CI: 5.7% to 11.4%) vs. 4.2% (95% CI: 2.7% to 7.2%) in the delayed removal group (p=.03). There was no statistically significant difference in the rates of urinary tract infection between the groups at 7.2% (95% CI:4.7% to 10.8%) in the delayed group vs. 4.7% (95% CI: 2.8% to 7.8%) in the immediate group. Conclusions: Rates of urinary retention and urinary tract infection following non-hysterectomy benign gynecological laparoscopy are low. There is a small increased risk of urinary retention with immediate compared with delayed removal of urinary catheter. These findings can be used to counsel patients regarding postoperative bladder care.
15 Aug 2022Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
19 Sep 2022Submission Checks Completed
19 Sep 2022Assigned to Editor
23 Sep 2022Reviewer(s) Assigned
28 Oct 2022Review(s) Completed, Editorial Evaluation Pending
11 Nov 2022Editorial Decision: Revise Major
13 Dec 20221st Revision Received
14 Jan 2023Submission Checks Completed
14 Jan 2023Assigned to Editor
14 Jan 2023Review(s) Completed, Editorial Evaluation Pending
17 Jan 2023Editorial Decision: Accept