Please select the eligibility criteria that correspond to the clinical trial below.
Title: When to Remove the Indwelling Catheter After Minimally Invasive Sacrocolpopexy?
Brief Summary: Objectives

The objective of this study is to help identify the best practice regarding the use of indwelling catheter after minimally invasive urogynecologic surgery. Investigators propose a randomized controlled trial comparing the immediate removal of indwelling urethral catheter, after minimally invasive sacrocolpopexy, to the present standard catheter removal on post operative day one. Evidence based catheter management will be helpful to both providers and patients in post-operative decision making.

Specific Aims

Aim 1: To demonstrate that immediate removal of catheter after minimally invasive sacrocolpopexy results in shorter hospital stay than removal on postoperative day 1.

Aim 2: To demonstrate that immediate removal of catheter after minimally invasive sacrocolpopexy confers no increased risk of re-catheterization.

Aim 3: To demonstrate that immediate removal of catheter after minimally invasive sacrocolpopexy decreases the occurrence of urinary tract infection.

Design

A randomized controlled trial comparing the standard overnight indwelling urethral catheterization with removal of catheter immediately post surgery after minimally invasive sacrocolpopexy, at Oregon Health \& Science University.

Outcome measures

Primary outcome measures are hospital stay in hours after completion of surgery and need for re-catheterization. Hospital stay will be counted from the time the patient leaves the operating room to the time she leaves the hospital. To avoid confounding, investigators are only including the first / morning case of the day. For re-catheterization, investigators will evaluate if patient was able to void after completion of surgery. Investigators will compare the post voiding residuals, the need for re-catheterizations and the numbers of patients going home with an indwelling catheter between the two groups. Investigators will also compare the number of urinary tract infections, as documented by urine culture and subsequent treatment, between the two groups.

Study Subjects

Study subjects will be women undergoing minimally invasive sacrocolpopexy. Women will be invited to participate in the study during their preoperative visit. If they agree to participation, this will be noted in their chart. Randomization to group will occur immediately following surgery.


Options:
A: Inclusion Criteria:

* Women undergoing minimally invasive sacrocolpopexy
* Sacrocolpopexy with or without concomitant procedures
* Patients having the first start surgery of the day to standardize hospital time.

Exclusion Criteria:

* Elevated post void residual (PVR)
* Mobility problems
* Neurological conditions
* Intra-operative cystotomy or urinary tract injury
B: Inclusion Criteria:

* Uterine fibroids
* Endometriosis
* Abnormal bleeding
* Uterine prolapse and intra-epithelial neoplasia of the cervix grade 3

Exclusion Criteria:

* If they experienced pelvic reconstructive surgery for pelvic organ prolapse or stress urinary incontinence
* If they have bacteriuria and clinical urinary tract symptoms, e.g. dysuria, frequency, urgency and stress incontinence before surgery
C: Inclusion Criteria:

* Females at least 18 years of age
* Understand and voluntarily sign an informed consent form
* English-speaking (able to read and understand English)
* Undergoing total laparoscopic hysterectomy for benign indication

Exclusion Criteria:

* Undergoing concomitant procedures in addition to hysterectomy which may cause urinary dysfunction
* Undergoing robotic-assisted laparoscopy or laparotomy
* Known history of pre-operative urinary incontinence or retention
* History of prior bladder or prolapse surgery
* Neurologic or spinal cord injury affecting bladder function
* Pregnant women
* Evidence of gynecologic malignancy
* Currently taking anticholinergic medications
D: Inclusion Criteria:

* age below 40 y.o.,
* surgery under spinal anesthesia,
* no previous history of urological problems.

Exclusion Criteria:

* opioid administration during surgery,
* need for urinary bladder catheterization during surgery,
* conversion to general anesthesia.

Answer: A