Influence of time for pulling out indwelling Foley catheter after transurethral resection of prostate on short-term and long-term complications
Objective To observe the effect of the time of pulling out the indwelling Foley catheter after transurethral resection of prostate(TURP)on the postoperative complications of patients with benign prostatic hyperplasia.Methods 300 patients with transurethral resection of the prostate(TUPR)were studied.150 patients with preoperative Urinary retention and indwelling catheterization or with diabetes were susceptible group,and 150 patients without infection self risk factors were normal group.The patients in the two groups were further divided into two subgroups,A and B.The Foley catheter was removed 24 hours after operation in group A,and the Foley catheter was removed 72 hours after operation in group B.Compare the recent complications after the removal of the Foley catheter,follow up the long-term complications such as urethral stricture,and compare the complications,prostate symptom score(IPSS),and maximum urinary flow rate(Qmax).Results The incidence of urinary retention after extubation in susceptible and normal patients in group A was 16.00%and 13.33%,both higher than that in group B(5.33%and 4.00%,respectively)(χ2=4.477,4.126,P<0.05).The incidence of secondary bleeding,Urinary incontinence,and bladder spasm had no statistical significance.The incidence of urinary tract infection in susceptible group B was slightly higher than that in susceptible group A,but there was no statistical significance between the groups(P>0.05).After extubation,patients with acute urinary retention were catheterized and kept the catheter for 4～5 days.Bleeding patients were reintroduced into the catheter,and water was injected into the balloon to continuously pull the catheter for compression and hemostasis.No bleeding and urinary retention occurred after extubation again.There was no statistically significant difference in the incidence of long-term complications such as urethral stricture and bladder neck contracture.Six months after surgery,Qmax in each group was higher than before surgery,the IPSS score was lower than before surgery,with statistically significant differences.There was no statistically significant difference in Qmax and IPSS between the groups after surgery.Multivariate analysis showed that prostate volume,diabetes,operation time and bladder neck fibrosis were the influencing factors of postoperative complications.Conclusion For patients with high risk factors of urinary tract infection who have routine and diabetes or have preoperative catheterization,extubation 72 hours after surgery do not increase the incidence of urinary tract infection compared with extubation 24 hours after surgery,and reduce the failure rate of extubation due to urinary retention and dysuria after extubation.
Benign prostatic hyperplasiaTransurethral resection of the prostateFoley catheterNurseComplications
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