Urinary retention after pelvic surgery is common and contributes to catheter-associated urinary tract infection (UTI). The aim of this study was to assess the effects of the implementation of a standardized voiding protocol in patients undergoing minimally invasive hysterectomy at a single cancer center in terms of the UTI rate, time to first void and overnight stays secondary to urinary retention.
We enrolled 102 consecutive patients undergoing minimally invasive hysterectomy at a single cancer centre during a 12-month period. A pre-intervention cohort of 100 consecutive patients was identified for comparison. A multidisciplinary team developed and implemented a standardized voiding protocol using quality improvement methodology. We compared the demographics, time to first void, rate of urinary retention, and UTI rates between the pre- and post-intervention cohorts.
Our intervention led to a significant reduction in the time to first void (289 vs. 566 minutes; p<0.001), rate of urinary retention (2% vs 10%; p=0.015) and post-operative UTI (4% vs 8%; p=0.249). There was a similar rate of patients going home with a Foley catheter (9% vs. 11%; p=0.850).
Implementation of a standardized voiding protocol was associated with a reduction in rate of UTI, time to first void and overnight stays secondary to urinary retention.
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 2022 May 01 [Epub ahead of print]
Soyoun Rachel Kim, Stéphane Laframboise, Gregg Nelson, Stuart A McCluskey, Lisa Avery, Nastasia Kujbid, Aysha Zia, Marcus Q Bernardini, Sarah E Ferguson, Taymaa May, Liat Hogen, Paulina Cybulska, Geneviève Bouchard-Fortier
Division of Gynecologic Oncology, Princess Margaret Cancer Centre/University Health Network/Sinai Health System, Toronto, Ontario, Canada., Department of Obstetrics & Gynecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network., Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.