Univariable analysis Multivariable analysis p value OR 95% CI p value OR 1.0 1.1 1.3 2.6 0.78 1.2 0.7 0.8 3.4 0.9 2.0 1.0 4.0 4.8 95% CI 1.0, 1.0 1.0, 1.2 0.6, 2.7 0.6, 11.5 0.2, 3.6 0.7, 2.4 0.3, 1.3 0.4, 1.7 1.6, 7.1 0.5, 1.8 1.1, 3.9 1.0, 1.0 1.9, 8.4 2.3, 10.2 Int Urogynecol J (2011) 22:477–483 0.75 0.05 0.46 0.21 0.75 0.52 0.26 0.58 <0.01 0.80 0.04 0.07 <0.01 <0.01 1.1 1.0, 1.2 0.09 2.3 0.8, 6.3 0.11 1.9 11.1 9.1 0.8, 4.7 3.8, 32.1 3.4, 23.8 0.12 <0.01 <0.01 482 Possible risk factors Table 4 Risk factors for temporary catheter replacement after anterior colporrhaphy Age BMI History Obstructive micturition Recurrent urinary tract infections Urinary tract infection in pre-operative sedimentation Pre-operative grade III cystocele (BW) Technique Kelly sutures Levator sutures Tobacco sutures Concomitant surgery Hysterectomy Posterior colporrhaphy Mean amount of blood loss in ml Protocol of 2 days catheterization (compared to 5 days catheterization) Urinary tract infection at the time of the first catheter removal contrast to others and to the theoretical concept, Kelly plication was not found an independent risk factor for repeated temporary catheterization in our study [8]. In our study, significantly less patients had urinary tract infections after 2 days than after 5 days of catheterization (22% versus 37%, p = 0.02). These findings are similar to previous studies, in which only 4% of patients had infections after removing the catheter on the first day postoperatively, compared to 20% on the third day and 40% on the fifth day [2, 4]. The presence of urinary tract infections was associated with a higher number of temporary catheter replacements both in the 2-day protocol and the 5-day protocol group. There are several weaknesses of this study that have to be acknowledged. One could criticize the choice of comparing catheterization for 2 and 5 days postoperatively. Many surgeons do remove the catheter earlier than after 5 days postoperatively. Nevertheless, in the literature, there is no clear evidence that it is better to remove a catheter shortly after pelvic floor surgery other than the subjective feeling that 5 days is long. The participating hospitals were used to give a catheter for 5 days, and referring to an average catheterization in 2003 of 3.7 days in the hospitals in The Netherlands, longer duration of catheterization was not uncommon [1]. One of the outcome measures of the study was the rate of urinary tract infections after the first catheter removal. In 20% of patients, no urine for culture was obtained after removal of the catheter. With 196 patients, the power of the study for this question is still sufficient, but it is likely that in patients with complaints, the risk of forgetting to obtain urine for culture is not that high as in patients with no complaints. It is possible that the percentage of infections was lower if cultures had been taken in all 245 patients. Because this protocol violation occurred equally in both arms (27 versus 24 patients), it causes no differences between the two arms of the study. Conclusions Based on the results of this study, we advise removing an indwelling catheter after an anterior repair on the second day postoperatively, followed by taking a urine culture. In case of a urinary tract infection, the risk of temporary catheter replacement is increased. Acknowledgements We would like to thank Prof. Dr. J.L.H. Evers for reading and commenting the manuscript. Financial support None. Conflicts of interest None. Open Access This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which per- mits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.