Early versus Delayed Removal of Urinary Catheter after Laparoscopic Hysterectomy: Insights from a Prospective Observational Study.

ObjectiveThis study aimed to compare the outcomes of early versus delayed removal of the urinary catheter after total laparoscopic hysterectomy (TLH), focusing on urinary retention, re-catheterization, urinary tract infection (UTI), and hospital stay duration.Subjects and methodsA prospective observational study was conducted, enrolling patients who underwent TLH. Participants were divided into two groups based on the timing of urinary catheter removal: early removal (immediately post-surgery) and delayed removal (≥18-24 h post-surgery). The primary outcomes included the incidence of temporary urinary retention (inability to void within 6 h of catheter removal requiring re-catheterization, the rate of UTI, and the duration of hospital stay). Statistical analyses were performed to compare outcomes between the two groups.ResultsA total of 128 women were analyzed (early catheter removal [ECR]: 62, delayed catheter removal: 66). Early removal of the urinary catheter was associated with an increased risk of temporary urinary retention. The risk difference was 9.7% (95% confidence interval [CI] [2.3-17.0]); P = 0.028) and a higher rate of re-catheterization (10.9% [95% CI 3.23-18.30]; P = 0.01). The incidence of UTIs was lower in the early removal group (1.53% vs. 7.69%), although this difference was not statistically significant (P = 0.20). Patients in the early removal group had a significantly shorter hospital stay (2.91 ± 0.9 days vs. 2.97 ± 0.6 days, P = 0.05).ConclusionECR after laparoscopic hysterectomy increases the risk of transient urinary retention and re-catheterization, with a possible trend toward lower UTI rates and a modest reduction in hospital stay. A risk-stratified, individualized approach may be preferable.