Prospective, multicentre, randomized controlled trial of bladder filling prior to trial of void on the timing of discharge
- J. Du MBChB, PGDipSurgAnat; D. Marshall MBChB; J. Leyland MBChB, FRACS (Urol); L. Shaw MBChB, FRACS (Urol); K. E. Broome MBChB, FRACS (Urol); D. F. C. Mason MBChB, FRACS (Urol).
Dr Jason Du, Department of Urology, Hawkes Bay Hospital, Omahu Road, Hastings 4120, New Zealand. Email: email@example.com
The objective of this study was to investigate whether bladder filling with saline prior to trial of void (TOV) was safe and whether it reduced time to discharge compared with standard TOV in the urology inpatient setting for patients post-transurethral resection of prostate, bladder neck incision or an admission with urinary retention.
Prospective, multicentre, randomized controlled trial at Hawkes Bay and Waikato hospitals with local ethics committee approval. All consecutive, consented patients requiring TOV were randomized into filling and control groups. The filling groups were filled with normal saline prior to TOV (up to 500 mL or first sensation of fullness). The control group had their catheter removed at 06.00 hours without filling. Time taken between catheter removal and discharge was recorded in minutes. Complications were recorded.
Fifty-two patients were recruited and randomized with 27 and 25 patients in the filling and control groups, respectively. The mean time taken from catheter removal to discharge was 300.6 min in the filling group and 340.1 min in the control group. The filling group reduced the time to discharge by 39.5 min (P = 0.304). Furthermore, 2/27 and 2/25 patients in the filling and control groups, respectively, developed urinary retention after TOV and required re-catheterization prior to discharge.
Bladder filling prior to TOV showed a non-statistically significant reduction in the time to discharge of 39.5 min. Despite the fact that bladder filling is a safe and cheap procedure, it cannot be recommended for use in an attempt to reduce time to discharge in an inpatient setting.