Early Catheter Removal Adds No Significant Morbidity Following Transurethral Resection Of The Prostate: A Systematic Review And Meta-Analysis

Background and Objective: Delayed catheter removal is a conventional procedure following transurethral resection of the prostate (TURP) but it remains controversial. The aim of our study was to identify whether delayed catheter removal was necessary following TURP. Materials and Methods: Electronic databases including PubMed, Embase, the Cochrane Library and the Science Citation Index were searched for relevant randomized controlled trials (RCTs). Two reviewers independently screened the search records from the electronic databases to identify the studies that met the inclusion criteria, evaluated the quality of the studies and abstracted the data. The pooled analyses of the outcome data were conducted with Review Manager 5.3 software. Results: Seven RCTs with 864 patients who underwent TURP were ultimately included in the meta-analysis. The early catheter removal after the surgery did not significantly add to the risk of re-catheterization [relative risk (RR) 1.12, 95% confidence interval (CI) 0.73 to 1.72] and secondary haemorrhage (RR 1.07, 95% CI 0.54 to 2.13) compared with the conventional delayed catheter removal following TURP. Nevertheless, the delayed catheter removal was associated with urinary tract infections (RR 0.46, 95% CI 0.24 to 0.91) and longer hospital stays (SMD -1.33, 95% CI -2.22 to -0.44). Conclusion: Early catheter removal does not significantly increase the risk of re-catheterization and haemorrhage while it reduces incidences of UTI and shortens hospital stays.