Management of urethral catheter related pain in renal transplant recipients: A clinical audit

Sasikumar. S

Consultant Urologist, Department of Urology, Kauvery Hospital, Tennur, Trichy

Background

Abstract

Ureteroneocystostomy is the crucial step in Renal Transplant. Continuous Bladder Drainage (CBD) is essential for first 4-5 days and 20Fr Urethral Catheter is a standard size for the treatment. This audit deals the Catheter Related Pain/Discomfort and their treatment of choice.

Methods and Materials

Place of Audit: Kauvery Hospital, Tennur

Duration: 2 year (January 2022December 2023)

Sample size: 215

Department: Urology

Purpose and Summary

  1. How many patients suffered?
  2. How did we manage?
  3. What were the corrections done?
  4. What was the final result?

Results and Discussion

On 20 Fr Silicon Foley

  1. 45% had Catheter related pain/discomfort
  2. 10% managed with single dose of Drotaverine and Solifenacin/Tolterodine
  3. 90% managed with maximum dose of Solifenacin/Tolterodine till catheter removal.

On 20 Fr Foley Catheter

  1. 46% had Catheter related pain and discomfort
  2. 5% treated with single dose of Drotaverine and Solifenacin/Tolterodine
  3. 95% treated with maximum dose of Solifenacin/Tolterodine till catheter removal.

On 18 Fr Silicon Catheter

  1. 33% had urethral pain/discomfort
  2. 20% managed with single dose of Drotaverine and Solifenacin/Tolterodine
  3. 80% managed with maximum dose of Solifenacin/Tolterodine till catheter removal.

On 16 Fr Silicon Catheter

  1. 10% had urethral pain/discomfort
  2. 65% managed with single dose of Drotaverine and Solifenacin/Tolterodine
  3. 35% managed with maximum daily dose of Solifenacin/Tolterodine till catheter removal.

Size of urethral catheter

No. of cases

No. of cases suffered

Percentage

20 Fr Silicon 65 30 45
20 Fr Foley 13 6 46
18 Fr Silicon 35 12 33
16 Fr Silicon 102 10 10
Catheter

Conclusion

  1. Catheter related pain/discomfort is a distressing complication of urethral catheter
  2. Pain is more bothersome than surgical site pain
  3. Challenging task to treat
  4. Change in catheter size (16Fr) significantly reduced the incidence of complication.
Sasikumar

Dr. S. Sasikumar

Consultant Urologist

Kauvery Hospital