Duration of urethral catheterization after urethroplasty: how long is enough?

Minerva Urol Nefrol. 2017 Aug;69(4):372-376. doi: 10.23736/S0393-2249.16.02639-4. Epub 2016 Apr 20.

Abstract

Background: To report the impact of duration of urethral catheterization (DUC) on the rate of extravasation on voiding cysto-urethrography (VCUG) and the subsequent need of catheter replacement in urethroplasty.

Methods: Two hundred nineteen consecutive patients undergoing urethroplasty between October 2010 and November 2014 were evaluated for the impact of DUC. Patients were divided into 2 groups, based on the scheduled DUC≤10 days (group 1, N.=86) or >10 days (group 2, N.=133).

Results: Fourteen patients (6.4%) had extravasation on VCUG with an additional period of catheter usage. In 10 of the 14 patients (71.4%) clinical signs of impaired wound healing were present. In group 1 (median DUC 8 days) 3 patients (3.5%) needed an additional period of urethral catheterization, compared to 11 patients (8.3%) in group 2 (median DUC 14 days). Strictures in group 2 were longer (4 vs. 2 cm, P<0.001) and more complex. Redo urethroplasty was needed in 9 of the 14 patients with extravasation.

Conclusions: In uncomplicated cases of urethroplasty, the urethral catheter can be safely removed after 8 to 10 days postoperatively. Extravasation on VCUG occurs in around 6% of urethroplasties and is a prognostic factor for stricture recurrence and reoperation.

MeSH terms

  • Female
  • Humans
  • Male
  • Postoperative Care / methods
  • Reoperation / statistics & numerical data
  • Urethra / surgery*
  • Urethral Stricture / surgery
  • Urinary Catheterization / adverse effects
  • Urinary Catheterization / methods*
  • Urinary Catheterization / statistics & numerical data
  • Urologic Surgical Procedures / methods*