LAPAROSCOPIC SURGERY- IS IT NECESSARY TO
CATHETERISE BLADDER
M.Ramalingam, C.Brown, DA.McMurray.
Wishaw General Hospital, Wishaw.
BACKGROUND: Catheterisation of the bladder is routine practise used for
all the patients undergoing routine laparoscopic procedures. This is not
an evidence-based practise and there is a risk of urinary tract
infections and postoperative urinary symptoms.
AIM: The aim of the audit is to assess the residual bladder volume in
patients undergoing Laparoscopic surgery by establishing a new practise
of asking the patient to empty bladder before they come to the theatre.
METHOD: This is a prospective study done between September 2005 to
February 2006 and all the patients undergoing Laparoscopic procedures
only as a Day case procedure were included in the study. Patients were
asked to empty bladder before coming to the theatre. Residual baldder
volume was measured using an in and out catheter before start of
procedure. The time patient emptied bladder and the time they were
catheterised were also noted.
RESULTS: A total number of 50 patients were recruited for the study
All the patients emptied bladder before coming to theatre. Of the
Total number of patients 25 underwent Laparoscopy and dye, 15
Laparoscopic Sterilisation and 10 Diagnostc Laparoscopy.The average
Residual bladder volume was 4.73mls.The average time interval between
Patient emptying bladder and bladder to be catheterised is 12.04
minutes. The least bladder volume measured was 0 mls and the maximum
was 26 mls with a respective time interval was 10 and 20 minutes
Respectively.
DISCUSSIONS: The average residual bladder volume of 4.73 mls is not
adequate enough to distend the bladder to make them prone to bladder
injury during laparoscopic procedures. The policy of asking patients
to empty bladder just before coming to theatre and noncatheterising
patients is safe and feasible for patients undergoing laparoscopic
procedures as a Day case surgery. The average time interval between
patients bladder and catheterising them is only 12.04 minutes is
reasonable.