A meta-analysis comparing suprapubic and transurethral catheterization for bladder drainage after abdominal surgery

Mcphail, M.J.W., Abu-Hilal, M. and Johnson, C.D. (2006) A meta-analysis comparing suprapubic and transurethral catheterization for bladder drainage after abdominal surgery. British Journal of Surgery, 93 (9), 1038-1044. (doi:10.1002/bjs.5424).

Abstract

Background: Although bladder drainage is widely used for general surgical patients undergoing laparotomy, there is little consensus on whether suprapubic or transurethral catheterization is better.

Method: A systematic database search was undertaken to find all studies of suprapubic catheterization. Randomized controlled trials were identified for inclusion. Endpoints for analysis were bacteriuria, patient satisfaction and recatheterization rates. A meta-analysis was performed using fixed-effect or random-effect models as appropriate, depending on heterogeneity.

Results: After abdominal surgery, transurethral catheterization is associated with significant bacteriuria (relative risk (RR) = 2·02, P < 0·001, 95 per cent confidence interval (c.i.) 1·34 to 3·04) and pain or discomfort (RR = 2·94, P = 0·004, 95 per cent c.i. 1·41 to 6·14). Recatheterization rates using the transurethral method were not increased significantly (RR = 1·97, P = 0·213, 95 per cent c.i. 0·68 to 5·74) with heterogeneity between studies.

Conclusion: The suprapubic route for bladder drainage in general surgery is more acceptable to patients and reduces microbiological morbidity.

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