An expert multidisciplinary panel using robust methodology has developed recommendations for guiding urinary catheter management after transurethral surgery for BPH.
As described in a recently published article (Am J Manag Care 2019; 25:e366-372), the group agreed that the catheter should be removed approximately 24 hours after uncomplicated transurethral surgery and that prolonged catheterization should be avoided in the event there was no clinically significant perforation sustained at the time of surgery.
“Transurethral surgical management of BPH is one of the most common procedures done by urologists, and although there are guidelines with regard to treatment choice, there are none to inform the duration of catheterization postoperatively,” said co-author Casey A. Dauw, MD, assistant professor of urology, University of Michigan, Ann Arbor.
“Our group has addressed this gap using the RAND/UCLA Appropriateness Method that couples scientific evidence with expert clinical judgment to develop what we believe are valid recommendations that will be clinically useful for urologists. In addition, we believe that our recommendations will be helpful for payers and patients because by promoting timely catheter removal, they can minimize the downstream complications associated with urinary catheterization and the negative impact it has on quality of life.”
Lead author Ted Skolarus, MD, MPH, assistant professor of urology, University of Michigan, told Urology Times, “It seems the robust methodology used to develop these recommendations, coupled with the lack of guidelines to postoperative catheter duration, should facilitate their implementation into routine practice with the ultimate goal of improving the consistency and quality of care for patients undergoing transurethral surgery for BPH.”
The RAND/UCLA Appropriateness Method has been used to define appropriate care in various clinical areas, including for active surveillance of prostate cancer, and has been shown to be predictive of results of subsequent randomized controlled clinical trials. It includes a systematic literature review to identify relevant articles and a clinician panel rating process.