Suprapubic versus transurethral bladder catheterization following pelvic surgery

PURPOSE OF REVIEW: There is uncertainty regarding the optimal method of achieving bladder drainage at the time of gynaecologic surgery. As both transurethral catheterization (TUC) and suprapubic catheterization (SPC) have the potential to cause harm, it is important that gynaecologists have accurate evidence upon which to base their bladder drainage policy. RECENT FINDINGS: Several clinical trials and meta-analyses have compared TUC with SPC in abdominal and pelvic surgery. Most recently, a large meta-analysis pooled the results of 12 gynaecological trials and found that the use of SPC leads to fewer urinary tract infections (UTIs) without any major complications and without increasing the duration of catheterization or length of hospital stay. SUMMARY: Robust evidence shows that SPC use leads to fewer UTIs when compared with TUC use in gynaecologic surgery. However, SPC use is associated with an increased incidence of minor complications. Future research should aim to assess the acceptability of both SPC and TUC to patients who are undergoing gynaecologic surgery. The quality of similar data in relation to rectal pelvic surgery is poor in comparison to the data on gynaecologic surgery.