The Effect Of Early Postoperative Urinary Catheter Removal On Patient Satisfaction In Gynecologic Oncology

Objectives Patient satisfaction is an important aspect of quality health care. A urinary catheter is routinely maintained for the first night following major surgery on a gynecologic oncology service. However, urinary catheters are a potential source of patient dissatisfaction. Methods We conducted a prospective cohort QA study of 111 patients undergoing major surgery on a gynecologic oncology service between 2016–2018. In the first cohort, the urinary catheters were removed at 6 AM on postoperative (POD) day # 1. In the second cohort, the catheters were removed 4 hours after surgery. In both cohorts, a satisfaction survey was collected in the afternoon on POD # 1. The primary outcome was patient satisfaction with several secondary clinical outcomes. Results Thirty-three patients (29.7%) were excluded due to postoperative concerns, including hemodynamic instability and necessity for prolonged urinary catheterization. The majority of patients described their hospital experience as good or excellent (Cohort 1: 30/32, 93.8% vs. Cohort 2: 28/30, 93.3%). Overall, only a single patient (in Cohort 1) experienced acute urinary retention requiring urinary catheter replacement. There were no significant differences in the duration of hospital stay, frequency of urinary tract infections, and hospital readmissions. In Cohort 1, 97.7% of patients ambulated by noon on POD # 1, while 91.2% of patients in Cohort 2 ambulated by 6 AM. Conclusions Patient satisfaction and clinical outcomes with early postoperative urinary catheter removal following major surgery on a gynecologic oncology service were not inferior to routine removal the following morning. We recommend early removal unless otherwise indicated by postoperative concerns.