Self-discontinuation of Urinary Catheters in a Rural Population

Self-discontinuation of Urinary Catheters in Patients With Urinary Retention Following Gynecologic Surgery in a Rural Population

The goal of this study is to understand patient satisfaction with two different ways of managing difficulty urinating after gynecologic surgery with a focus on those patients who receive care in a rural area.

One common practice is to have an "office catheter removal." This means, if a patient has trouble urinating after surgery and goes home with a foley catheter, they usually have to come back to the clinic within 2-3 days to have the catheter removed and to do a test to see if they can urinate on their own. For some patients, coming back to the clinic so soon after surgery can be difficult, especially for those patients who live far away or are dependent on others for getting to appointments.

A second, less common, practice is to have patients remove their own catheter at home, or "self-removal of urinary (Foley) catheter." With self-removal, patients remove their Foley catheter at home, and confirm that they are urinating normally. This approach has been shown to be safe, with similar patient satisfactions, and success, but those studies did not take into account situations where patients may live a rural area and/or travel a long distance to the medical center to receive care.

This study is comparing the in-office removal with self-removal. The goal is to find out which option patients prefer, how convenient each approach is, and how well they work. The main goal of this study is to understand patient satisfaction and improve care after surgery.

Inclusion Criteria:

1. Adults aged 18 years or older
2. Undergoing gynecologic surgery with planned postoperative trial of void to confirm normal voiding prior to discharge home
3. Willing and able to provide informed consent
4. English-speaking
5. Willing to comply with study procedures, including follow-up phone calls and surveys

Exclusion Criteria:

1. Known urinary tract abnormalities (e.g., urethral strictures, neurogenic bladder) that may affect voiding.
2. Diagnosis of voiding dysfunction prior to surgery with need to self-catheterize.
3. Perioperative complication that necessitates indwelling catheter for a specific duration of time.
4. Joint surgeries that would affect ability to comply with study methods (e.g. that necessitates longer inpatient admission or reduces mobility beyond that normal for postop patients after gynecologic surgery)
5. Presence of significant cognitive or physical impairments that limit the ability to comply with study procedures.