Is the Use of 2-Way Catheter Post-TURP Safe?

Introduction: We present a retrospective study involving 48 patients, who underwent transurethral resection of the prostate (TURP) for bladder outflow obstruction due to prostatic enlargement [4]. The aim of the study was to compare the safety of 2-way catheters post-TURP in relation to the 3-way catheter.

Materials & Methods: We selected all those patients who had undergone TURP from March 2005 to October 2005. In most of the cases the obstruction to bladder outflow was due to benign disease. The decision about the type of catheter to be put in was purely the surgeon's choice. The case notes for these patients were requested from the medical records department after proper permission from the ethics and research committee was obtained. Out of a total 48 patients, 20 patients had 2-way catheters inserted postoperatively, and 28 had a 3-way catheter. The details about the operative and postoperative course and events were obtained from the operation notes, the nursing notes, the postoperative case notes, input-output charts, and other records. The data obtained was analyzed and interpreted.

Results: On analyzing the data, it was found that a 3-way catheter is a much safer option in post-TURP patients compared to the 2-way catheter. Seven (35%) of the twenty patients were found to have encountered some form of catheter-related problems. Five (25%) of these needed about 2 to 5 bladder washouts. One (5%) of them required more than 5 bladder washouts. But in 3 (15%) out of these, 20 patients with repeated bladder washouts did not resolve the problem and hence the catheter had to be changed from 2- to 3-way catheter as a last resort. No problems were noted in the 3-way catheter group.

Conclusion: In a small study we noticed that more problems were encountered with a 2-way catheter, and it did not give any distinct advantage over 3-way catheters in reducing postoperative catheterization time. We feel that the use of a 3-way catheter should be a standard practice, although irrigation can be commenced only if there are problems due to bleeding post-TURP.

KEYWORDS: Transurethral resection of the prostate (TURP), two-way (2-way) catheter, three-way (3-way catheter), bladder washouts, irrigation, normal saline, change of catheter, trial without catheter (TWOC)



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