Factors Predicting Catheter-Related Bladder Discomfort in Surgical Patients

PURPOSE

The study was conducted to identify the factors predicting catheter-related bladder discomfort (CRBD) in the postanesthesia care unit, to assess the level of CRBD and urinary catheter-related pain for the first 24 hours postoperatively, and to compare UCRP with the postoperative pain in the surgical site.

BACKGROUND

About 20% of hospitalized patients receive an indwelling urinary catheter, and more than half of these patients complain of CRBD or urinary catheter-related pain.

DESIGN

This prospective descriptive study conducted in an 800-bed university hospital involved 160 patients who had undergone elective surgery from February 5, 2012 to June 5, 2012.

METHODS

Demographic data including gender, age, American Society of Anesthesiologists class, weight, and height were collected on the preoperative visit. Factors predicting CRBD were identified by multiple logistic regression analysis. Comparison of the UCRP and postoperative pain was analyzed using the Mann-Whitney U test.

FINDINGS

Multiple logistic regression analysis showed that the factors predicting CRBD ≥2 30 minutes after arrival to the postanesthesia care unit were age <50 years (odds ratio [OR], 4.79; P = .005), male gender (OR, 7.07; P = .015), obstetric and gynecological surgery (OR, 11.07; P = .045), and UCRP (OR, 132.3; P < .015). Postoperative pain (P < .001) was significantly greater than UCRP.

CONCLUSIONS

Age <50 years, male gender, open abdominal surgery, and UCRP ≥4 predict CRBD.

CLINICAL RELEVANCE

Perioperative care providers should screen surgical patients for risk factors of CRBD during the first postoperative 12 hours.

Should antibiotics be prescribed when urinary catheters are removed?

Each year around one million urinary catheters are inserted in NHS hospitals. In around 60% of cases prophylactic antibiotics are prescribed prior to removal. This practice aims to reduce infection risks, but is not supported by evidence. Inappropriate prescribing increases antibiotic resistance, already a serious and worsening problem, and exposes patients to the hazards of antibiotic prescribing. This practice also costs an estimated £1.35-£2.7 million pounds annually. Nurses at all levels can have a huge influence on catherterization rates and catheter management. This can reduce the risks of harm and infection and improve quality of care.