Objective: To evaluate whether early removal of the urinary indwelling catheter enhances postoperative recovery in women undergoing uncomplicated total abdominal hysterectomy (TAH). Methods: This open-label randomized controlled trial was conducted at a university hospital in Thailand between August 2023 and July 2024. Women aged 18– 65 years scheduled for TAH for benign gynecologic conditions were randomized to early catheter removal (12– 16 hours postoperatively) or standard removal (20– 24 hours). Primary outcomes were time to first ambulation and six-minute walk test (6MWT) distance on postoperative days (POD) 1 and 2. Secondary outcomes included time to first voiding, urinary retention, urinary tract infection (UTI), catheter-related discomfort, hospital stay, costs, and patient satisfaction. Results: Of 105 patients screened, 100 were randomized; 93 completed the study (46 early removal, 47 standard removal). Baseline characteristics were comparable. Early catheter removal significantly reduced time to ambulation (18.69 ± 4.11 vs 21.41 ± 3.02 hours, p < 0.001) and time to first voiding (19.02 ± 3.72 vs 21.99 ± 3.46 hours, p < 0.001). 6MWT distances on POD1 and POD2 were slightly higher in the early group but not statistically different. Rates of urinary retention, symptomatic UTI, catheter-related discomfort, hospital stay, hospitalization costs, and patient satisfaction were similar across groups. Conclusion: Early urinary catheter removal within 12– 16 hours after uncomplicated TAH accelerates postoperative recovery, particularly ambulation and voiding, without increasing urinary complications, supporting its integration into ERAS protocols. Keywords: catheter removal, hysterectomy, recovery
Karasaard et al. (Sun,) studied this question.