Management of Bladder Drainage Following Vaginal Plastic Repairs

A controversy exists concerning the most appropriate method of bladder drainage after vaginal hysterectomy and anterior-posterior repair. The present study compares the use of the Foley catheter and the suprapubic tube following these operations. One hundred and fifty suitable candidates were selected, with 75 using each system. The results showed that the suprapubic group had one-third the rate {12% vs 38%) of significant bacteriuria when compared to the Foley group at the time the instruments were removed on the fourth postoperative day. In addition the Foley group also had a significant increase in the number of positive urine cultures 6 weeks after the operation (10% vs 2%), a higher incidence of prolonged hospitalization (greater than 6 days), and a more frequent use of bladder analgesics (69% vs 41%). Other advantages in the use of suprapubic tubes after vaginal surgery appeared to be ease of care by ward personnel, greater patient comfort, and a reduced incidence of severe complications. An additional finding of this study was related to the increase of significant bacteriuria in patients receiving cold knife conization prior to hysterectomy. This factor appeared to be constant regardless of the drainage system used although a greater number of cases were found in the Foley group.