Clinical evaluation of immediate removal of transurethral catheter after radical gastrectomy: A result of feasibility study

Purpose: Transurethral catheterization is restricted to fewer procedures and a limited time with an increase in enhanced recovery after surgery (ERAS) programs or fast-track surgical procedures. We aim to evaluate the feasibility of immediate removal of transurethral catheter in hemodymically stable patients undergoing radical gastrectomy prior to a prospective randomized control trial. Methods: A total 63 gastric cancer patients undergoing elective radical gastrectomy were enrolled in a feasibility study. Patients were randomized to either the active group (immediate removal group) or control group (removal at postoperative day 1 group) with blinding, and 58 patients were finally included. Amount of residual and voiding urine, operative factors (operation time, infused fluid, urine output, and blood loss), first voiding discomfort level, urinary discomfort score, and urine analysis were measured. Results: In the active group, the self-voiding volume and residual urine volume measured nearly equal (256 ml vs 244 ml) at 16 hours after transurethral catheter removal. The discomfort score of first self-voiding was lower in active group (P=0.041). Regarding urinary discomfort at postoperative day 2 and the urine analysis at postoperative day 5, there were no significant differences between the 2 groups. Conclusion: Immediate removal of the transurethral catheter could be feasible and safe in hemodynamically stable patients undergoing radical gastrectomy in aspects of ERAS programs. A prospective randomized controlled trial would be scheduled for acceptable evidence. (J Korean Surg Soc 2010;79:189-195).