Teaching patients clean intermittent self-catheterisation prior to anti-incontinence or prolapse surgery: Is it necessary in women with obstructive voiding dysfunction?

Purpose To determine the value of pre-operative teaching of clean intermittent self-catheterisation (CISC) in women who undergo anti-incontinence and/or prolapse surgery and who are at 'high risk' to have post-operative incomplete bladder emptying. Methods Out of the 402 patients who underwent anti-incontinence and/or prolapse surgery at our institute (March 2008-March 2009), 48 patients had at least one obstructive lower urinary tract symptom and one obstructive urodynamic parameter before surgery and were considered at 'high risk' to have post-operative incomplete bladder emptying. They were taught CISC pre-operatively. Results Out of the 48 patients, 7 (14.6%) had incomplete bladder emptying. The incidence of postoperative incomplete bladder emptying was higher in the older women (P<0.01) but was not affected by the type of surgery or by any particular pre-operative urodynamic parameter. None of the patients in this 'high risk' group were required to perform CISC postoperatively. Conclusions Routine teaching of the technique of CISC to 'high risk' patients prior to anti-incontinence and/or prolapse surgery appears to be an unnecessary use of valuable nursing time as well as being an invasive intervention which is unlikely to be required post-operatively.