Early versus delayed removal of urinary catheter after Pelvic organ prolapse surgery and vaginal hysterectomy: A systematic review and meta-analysis of randomized controlled trials | ||||
| Evidence Based Women's Health Journal | ||||
| Articles in Press, Accepted Manuscript, Available Online from 24 May 2022 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ebwhj.2022.127684.1173 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Khaled Hammam1; Ahmed Ali2; Esraa Ayman3; Shymaa Abdel Hamid4; Hussien Se'eda5; Sara Elsayed6; Ahmad Anwar5; Fatma Saad7; Aya Ali5; Mohamed Ramadan8; Amr Hussein  8
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| 1MBBCh, Medicine and Surgery, Faculty of Medicine and Surgery, October 6 University, Giza, Egypt. 2 International Medical Students Research Association | ||||
| 2International Medical Students Research Association. MBBCh, Medicine and Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. | ||||
| 3International Medical Students Research Association. MBBCh, Medicine and Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt. | ||||
| 4International Medical Students Research Association. MBBCh, Medicine and Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt. | ||||
| 5Minia Medical Research Society (MMRS), Minia University, Egypt Department of Medicine and Surgery, Faculty of Medicine | ||||
| 6MBBCh, Medicine and Surgery, Faculty of Medicine and Surgery, October 6 University, Giza, Egypt. International Medical Students Research Association | ||||
| 7Faculty of Pharmacy, Minia University, Egypt. Minia Medical Research Society (MMRS), Minia University, Egypt | ||||
| 8Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt. | ||||
| Abstract | ||||
| Material and Methods We searched the literature from inception till April 2019 using PubMed, Web of Science, Scopus, WHO Global Health Library (GHL), Virtual Health Library (VHL), System for Information on Grey Literature in Europe (SIGLE), POPLINE, and Cochrane Central Register of Controlled Trials (CENTRAL). We screened the retrieved records for their eligibility and extracted baseline and outcomes data. We performed quality assessment using the Cochrane risk of bias assessment tool. continuous data were pooled as mean difference (MD) and dichotomous data as relative risk (RR) with their corresponding 95% confidence intervals (CIs) in a random-effects model. We analyzed data using Review Manager 5.3 for windows. Results Nine studies (N= 1116 patients) were included in the final meta-analysis. Overall effect estimates favored early catheter removal group in comparison to delayed catheter removal group in the following outcomes; Urinary tract infection (UTI) (RR=0.42, 95% CI [0.24, 0.72], P=0.0002), Symptomatic urinary tract infection (SUTI) (RR=0.23, 95% CI [0.11, 0.48], P=0.0001), length of hospitalization (MD= -0.89, 95% CI [-1.26, -.52], P=0.0001). Whereas, the pooled effect estimates favored delayed removal group over the early removal group regarding re-catheterization (RR=2.75, 95% CI [1.86, 4.07], P=0.0001). There was no significant difference between the two groups regarding urinary retention (RR=1.45, 95% CI [0.80, 2.63], P=0.22). Conclusion Early catheter removal is better than delayed catheter removal in decreasing the risk of urinary tract infection, symptomatic urinary tract infection, the length of hospitalization. However, delayed catheter removal reduced post-operative re-catheterization events. The risk of urinary retention was comparable . | ||||
| Keywords | ||||
| Pelvic organ prolapse; vaginal hysterectomy; catheterization; early; delayed | ||||
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