Comparing clean intermittent catheterisation and transurethral indwelling catheterisation for incomplete voiding after vaginal prolapse surgery: a multicentre randomised trial

BJOG. 2011 Aug;118(9):1055-60. doi: 10.1111/j.1471-0528.2011.02935.x. Epub 2011 Apr 11.


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.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Bacteriuria / etiology
  • Bacteriuria / prevention & control
  • Catheters, Indwelling*
  • Female
  • Humans
  • Middle Aged
  • Patient Satisfaction
  • Postoperative Complications / therapy*
  • Time Factors
  • Urinary Catheterization / methods*
  • Urinary Retention / etiology
  • Urinary Retention / therapy*
  • Urinary Tract Infections / etiology
  • Urinary Tract Infections / prevention & control
  • Uterine Prolapse / surgery*