Comparing clean intermittent catheterisation and transurethral indwelling catheterisation for incomplete voiding after vaginal prolapse surgery: a multicentre randomised trial: Optimising treatment of incomplete voiding
Abstract
OBJECTIVE: To compare clean intermittent catheterisation with transurethral indwelling catheterisation for the treatment of abnormal post-void residual bladder volume (PVR) following vaginal prolapse surgery. DESIGN: Multicentre randomised controlled trial. SETTING: Five teaching hospitals and one non-teaching hospital in the Netherlands. POPULATION: All patients older than 18 years experiencing abnormal PVR following vaginal prolapse surgery, with or without the use of mesh. Exclusion criteria were: any neurological or anxiety disorder, or the need for combined anti-incontinence surgery. METHODS: All patients were given an indwelling catheter directly after surgery, which was removed on the first postoperative day. Patients with a PVR of more than 150 ml after their first void were randomised for clean intermittent catheterisation (CIC), performed by nursing staff, or for transurethral indwelling catheterisation (TIC) for 3 days. MAIN OUTCOME MEASURE: Bacteriuria rate at end of treatment. RESULTS: A total of 87 patients were included in the study. Compared with the TIC group (n = 42), there was a lower risk of developing bacteriuria (14 versus 38%; P = 0.02) or urinary tract infection (UTI; 12 versus 33%; P = 0.03) in the CIC group (n = 45); moreover, a shorter period of catheterisation was required (18 hours CIC versus 72 hours TIC; P < 0.001). Patient satisfaction was similar in the two groups, and no adverse events occurred. CONCLUSION: Clean intermittent catheterisation is preferable over indwelling catheterisation for 3 days in the treatment of abnormal PVR following vaginal prolapse surgery.
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Four trials with a total of 582 women evaluated POP surgery and management of catheters once trial of void (TOV) fails.
“POP surgery and management of catheters once trial of void (TOV) fails: four trials with a total of 582 women (Boyd 2019; Hakvoort 2011; Shatkin‐Margolis 2019; Weemhoff 2010).”
From Perioperative interventions in pelvic organ prolapse surgery (2025) · cites this paper as Hakvoort 2011
In women who fail their TOV after POP surgery, the CISC control group (with day 3 IDC removal as intervention) had fewer urinary tract infections (OR 0.28, 95% CI 0.09 to 0.87; 1 study, 87 women).
“Hakvoort 2011 found that in the CISC control group (intervention arm was day 3 IDC removal), there were fewer urinary tract infections (OR 0.28, 95% CI 0.09 to 0.87; 1 study, 87 women).”
From Perioperative interventions in pelvic organ prolapse surgery (2025) · cites this paper as Hakvoort 2011
One trial found that women were less likely to develop UTIs when using clean intermittent self-catheterisation (5 of 45 women; 12%) as opposed to an IDC for three days (13 of 42 women; 33%).
“One trial found that women were less likely to develop UTIs when using clean intermittent self‐catheterisation (CISC; 5 of 45 women; 12%) as opposed to an IDC for three days (13 of 42 women; 33%) (P = 0.03) (Hakvoort 2011).”
From Perioperative interventions in pelvic organ prolapse surgery (2025) · cites this paper as Hakvoort 2011
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- Authors
- Hakvoort, R., Thijs, S., Bouwmeester, F., Broekman, A., Ruhe, I., Vernooij, M., Burger, M., Emanuel, M., & Roovers, J.
- Affiliations
- Spaarne Ziekenhuis (NL)
- Waterlandziekenhuis (NL)
- Elisabeth-TweeSteden Ziekenhuis (NL)
- Flevoziekenhuis (NL)
- St. Antonius Ziekenhuis (NL)
- Amsterdam UMC Location University of Amsterdam (NL)
- Corresponding author
- Hakvoort, RA
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2011-04-11
- Volume
- 118
- Issue
- 9
- Pages
- 1055-1060
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- OpenAlex
- W2142715054
- Cited by
- 99
- References
- 31
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2023: 8 · 2022: 5 · 2021: 7 · 2020: 8 · 2019: 9 · 2018: 7 · 2017: 11 · 2016: 2 · 2015: 6 · 2014: 7 · 2013: 6 · 2012: 9
- FWCI
- 11.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Topics
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Epidemiology › Urinary Tract Infections Management
- Keywords
- clean intermittent catheterization, post-void residual urine, vaginal prolapse surgery, mesh repair, bacteriuria, urinary tract infection, catheter dwell time, patient satisfaction
- MeSH terms
- Bacteriuria, Catheters, Indwelling, Female, Humans, Middle Aged, Postoperative Complications, Time Factors, Urinary Catheterization, Urinary Tract Infections, Uterine Prolapse, Urinary Retention, Patient Satisfaction
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