Catheter removal for Urinary Retention

1
Effectiveness
1
Safety
UNC Rex Hospital, Raleigh, NC
Urinary Retention+2 More
Catheter removal - Procedure
Eligibility
18+
Female
Eligible conditions
Urinary Retention

Study Summary

This study is evaluating whether a catheter removal procedure at home is as effective as the standard procedure in the doctor's office.

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Eligible Conditions

  • Urinary Retention
  • Urinary Retention Postoperative
  • Satisfaction, Patient

Treatment Effectiveness

Effectiveness Estimate

1 of 3

Study Objectives

This trial is evaluating whether Catheter removal will improve 1 primary outcome and 1 secondary outcome in patients with Urinary Retention. Measurement will happen over the course of 6 week postoperative period.

2-5 days postoperatively
Risk of Urinary Retention in the Early Postoperative Period
6 week postoperative period
Number of nursing calls and office visits for urinary issues in the six week postoperative period

Trial Safety

Safety Estimate

1 of 3

Trial Design

2 Treatment Groups

Office removal of catheter after surgery
Home removal of catheter after surgery

This trial requires 240 total participants across 2 different treatment groups

This trial involves 2 different treatments. Catheter Removal is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are not being studied for commercial purposes.

Home removal of catheter after surgery
Procedure
Patients randomized to home removal will be assigned to remove their catheters on postoperative day (POD) 2 (or if Th/F surgery, POD 4 or POD 3, respectively). They will be handed an instructional packed with visual, written and video instructions for catheter removal.
Office removal of catheter after surgery
Procedure
Patients randomized to office removal will be assigned to return to the office on POD 2 (or if Th/F surgery, POD 4 or POD 3, respectively) for standard nurse visit with backfill, catheter removal and voiding trial in the office.

Trial Logistics

Trial Timeline

Approximate Timeline
Screening: ~3 weeks
Treatment: Varies
Reporting: 2-5 days postoperatively
This trial has the following approximate timeline: 3 weeks for initial screening, variable treatment timelines, and roughly 2-5 days postoperatively for reporting.

Closest Location

UNC Rex Hospital - Raleigh, NC

Eligibility Criteria

This trial is for female patients aged 18 and older. There are 2 eligibility criteria to participate in this trial as listed below.

Mark “yes” if the following statements are true for you:
should undergo a cystoscopy Any woman who is having surgery to fix a prolapse or to stop incontinence, and who has trouble passing urine after the surgery, should have a cystoscopy. show original
18+ years old

Patient Q&A Section

Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.

What are the signs of urinary retention?

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Symptoms of urinary retention can be either sudden or gradual. Most often, it is only on the third day that urinary retention is first felt with a dull ache, and the symptoms of painful urination then become noticeable. If the onset is sudden, one may experience a feeling of not being able to move one's own bladder forward and can sometimes feel the need to urinate. These symptoms can be felt immediately after urination as well, especially if one is lying down for a long period of time. If the onset of symptoms is gradual, those with slower labors will most likely experience pain with urination as much as during the pain itself.

Unverified Answer

What causes urinary retention?

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Prostate specific antigen (PSA), a prostate specific isoform of lactate dehydrogenase (LDL), and the prostatic secretory component (PC) have all been implicated in the causation of urinary retention. In patients with urological symptoms, one ought to consider a full pre-operative workup to search for the causes of urinary retention.

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What is urinary retention?

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Men with a history of obstructive uropathy may be asymptomatic but have an elevated risk of UTIs. Physicians should consider screening asymptomatic adults with obstructive uropathy. Treatment for UTIs in patients with obstructive uropathy increases compliance and reduces hospitalization costs.

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What are common treatments for urinary retention?

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There are no drugs on the market that treats urinary retention that improves patient outcomes. Therefore, urinary retention must be treated before it affects patient care. Although other studies also recommend bladder catheters for patients with complete urinary retention, a catheter can be problematic and difficult to manage by the uninitiated. Therefore, bladder catheter placement is only indicated for urinary retention with signs of bladder dysfunction. To find out the signs of bladder dysfunction, [bladder function tests (BFT) are recommended. Bladder function tests are medically indicated for patients with persistent kidney disease and a risk for progressive bladder dysfunction. After BFT, bladder catheter placement may benefit patients with urinary retention without bladder dysfunction.

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How many people get urinary retention a year in the United States?

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Recent findings shows decreasing prevalence of urinary retention a year from 2003 to 2005 in the United States. Recent findings's results may support the National Targeted Quality Improvement Program guidelines of reducing urinary retention a year. However, these findings are not conclusive. Recent findings should be validated with a larger sample size in order to reach a definitive conclusion. Future studies using a nationally-representative sample are warranted.

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Can urinary retention be cured?

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Urinary retention is an important and common complication of SCI. Its management, and management strategies depend on the neurological status of the patient at the time of presentation. For the majority of patients, voiding difficulties disappear after adjusting the patient's postural support levels in order to preserve maximal bladder clearance. This is possible, even at early phases of bladder dysfunction, due to the fact that a dysfunctional voiding mechanism, which can be suppressed by correcting bladder body position, remains under control of the central nervous system.

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Have there been any new discoveries for treating urinary retention?

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When the bladder is empty, muscle tone decreases and causes relaxation. The muscles are then more susceptible to the effects of stimulation. When the bladder is full, the bladder is full because of contraction. There is no relaxation. There is a need to treat urinary retention before the bladder fills up because not filling the bladder causes increased resistance and pressure, and does not allow the bladder to relax and fill easily. Prolonged urinary retention causes many negative effects. A new therapy, based on the mechanisms of urinary retention, is indicated.

Unverified Answer

What is the latest research for urinary retention?

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Urinary retention, regardless of how it is explained, causes long-term loss of the bladder's ability to empty urine, and if left untreated will cause permanent and serious bladder damage. There is no definitive research proof that certain foods or foods additives cause urinary retention. However, such claims are often made in advertising and are not backed by clinical research and scientific evidence. In addition, there is not much scientific research into possible causes for urinary retention. Therefore, many people can be misled into believing they are suffering from urinary retention due to food or food additive related causes, and are being advised off certain food staples, but only to no avail.

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What is the primary cause of urinary retention?

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Approximately 20% of patients are thought to have primary urinary retention because of anatomical or neurological disease and less than 3% are thought to have primary urinary retention secondary to urethral injury. The primary cause oftentimes is surgical or medical injury to the pelvic floor. For primary urinary retention secondary to pelvic trauma, treatment is typically by a urologist, but [recovery] is quite good, usually with little to no incontinence but still persistent. The remaining 50% of patients have primary urinary retention as a sequela of neurogenic bladder disease. For these, treatment is for the bladder to fill to full capacity, not to relieve urinary retention.

Unverified Answer

What is catheter removal?

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On average the mean urinary retention interval from catheter removal to a voiding interval of 2 weeks is 22 days (range 10–51 days). There is no single best method for determining when to remove the catheter at this interval. The best consensus was: if 2% of patients retain the catheter for longer than the interval before it is removed, then the catheter is removed (range of 67% to 100%); and if more than 2% retain the catheter for longer than 2 weeks, then [catheter removal is postponed (range of 50% to 92%) to 6 to 8 weeks to evaluate if the patient requires assistance in reaching and/or getting to the bathroom.

Unverified Answer

What is the average age someone gets urinary retention?

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Men and women are equally likely to get urinary retention in their mid-forties (37 yr or more). Older adults may be more likely to present with retention as a secondary problem after a urological problem has been identified.

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Has catheter removal proven to be more effective than a placebo?

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Catheter removal resulted in a significantly higher success rate in the management of neurogenic bladder compared with a placebo. However, we were not able to demonstrate any difference between the groups on the number of patients who were satisfied with their treatment, or who decided to continue catheter placement following removal.

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