Early versus Delayed Removal of Urinary Catheter after Laparoscopic Hysterectomy: Insights from a Prospective Observational Study.

OBJECTIVE: This study aimed to compare the outcomes of early versus delayed removal of the urinary catheter after total laparoscopic hysterectomy (TLH), focusing on urinary retention, re-catheterization, urinary tract infection (UTI), and hospital stay duration. SUBJECTS AND METHODS: A prospective observational study was conducted, enrolling patients who underwent TLH. Participants were divided into two groups based on the timing of urinary catheter removal: early removal (immediately post-surgery) and delayed removal (≥18-24 h post-surgery). The primary outcomes included the incidence of temporary urinary retention (inability to void within 6 h of catheter removal requiring re-catheterization, the rate of UTI, and the duration of hospital stay). Statistical analyses were performed to compare outcomes between the two groups. RESULTS: A total of 128 women were analyzed (early catheter removal [ECR]: 62, delayed catheter removal: 66). Early removal of the urinary catheter was associated with an increased risk of temporary urinary retention. The risk difference was 9.7% (95% confidence interval [CI] [2.3-17.0]); P = 0.028) and a higher rate of re-catheterization (10.9% [95% CI 3.23-18.30]; P = 0.01). The incidence of UTIs was lower in the early removal group (1.53% vs. 7.69%), although this difference was not statistically significant (P = 0.20). Patients in the early removal group had a significantly shorter hospital stay (2.91 ± 0.9 days vs. 2.97 ± 0.6 days, P = 0.05). CONCLUSION: ECR after laparoscopic hysterectomy increases the risk of transient urinary retention and re-catheterization, with a possible trend toward lower UTI rates and a modest reduction in hospital stay. A risk-stratified, individualized approach may be preferable.