Incomplete emptying of the bladder is one of the most common unwanted side effects of Pelvic Organ Prolapse (POP) surgery. The incidence varies widely between studies. Routine transurethral catheterization is the standard procedure after POP surgery. There is increasing trend of short period of catheterization following after uncomplicated vaginal hysterectomy. Early removal of catheter may lead to retention of urine due to reflex pain in the operation site and overfilling of the bladder after prolapse surgery which might  have a negative effect on surgical outcome. On the contrary, prolonged catheterization increases the chance of urinary tract infection; prevents early ambulation, prolongs hospital stay and also adversely impacts post-operative wellbeing.

Although several trials addressed the issue of the duration of catheterization after surgery, there is no consensus on how best to minimize complications of prolonged catheterization and practices vary. There was not enough evidence to show that any policy was better than the other.

At our institute the practices vary from 24-72 hours of indwelling catheterization (IDC) after POP surgery .In this study we will review 5 year experience of urinary retention in patients undergoing POP surgery with relation to duration of catheterization at our institute.

A retrospective study was conducted at the urogynaecology department between January 2013 to December 2017. All patients who were between 30-80 years and underwent Pelvic organ prolapse surgery were included in the study,exclusion criteria were
•	Concurrent UTI/surgery SUI 
•	Urethral abnormalities
•	Diabetic neuropathy
•	Women for whom complicated surgical procedure was anticipated (Patient with long standing prolapse with severe fibrosis).
•	Iatrogenic bladder injury 
•	Prolapse surgery associated with plan of bladder or vault Suspension or repair by mesh
 In all cases, pre-operative evaluation or examination under anesthesia was documented to define the type and grade of POP. Patients with complete medical records were reviewed and data on the type of surgery, duration of surgery, blood loss, anesthesia type, duration of catheterization, and urinary retention were recorded. Two groups were formed, group A - retention postoperatively and group B - without urinary retention. The duration of catheterization was compared between the two groups.

Postoperative urinary retention occurred in 11.4 % of the study subjects (19/166).Overall, our study examined the association with retention and demographic characteristics for women receiving pelvic organ prolapse surgery at a tertiary care center. Demographic characteristics of our study sample are described in Table  1.The mean age of patients was 55.8 ± 12.2 years and the mean body mass index (BMI) was 28.6 ± 6.2 kg/m2. The mean duration of surgery was approximately two and a half hours with a mean blood loss of 345 ± 305 ml.The study reported that the duration of the indwelling catheter was significantly associated with postoperative urinary retention (p=0.013) (Table 2). The lowest rate of postoperative retention was found in patients who were catheterized for at least 48 hours.Upon stratification, it was found that duration of surgery was significantly associated with postoperative urinary retention (p=0.012). Furthermore, it was revealed that the majority of the underweight patients, i.e. 3 (75%) suffered from postoperative retention (p<0.001) (Table 3).

The mean age of patients was 55.8 ± 12.2 years and the mean body mass index (BMI) was 28.6 ± 6.2 kg/m2. The study reported that the duration of the indwelling catheter was significantly associated with postoperative urinary retention (p=0.013). The lowest rate of postoperative retention was found in patients who were catheterized for at least 48 hours.
Upon stratification, it was found that the duration of surgery was significantly associated with postoperative urinary retention (p=0.012).

Postoperative urinary retention is a common condition encountered following pelvic surgery, which contributes to significant patient discomfort and anxiety. Our study revealed that the optimum duration of catheterization is 48 hours which could improve the patient outcome.

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Glavind K, Morup L, Madsen H, Glavind J. A prospective, randomised, controlled trial comparing 3 hour and 24 hour postoperative removal of bladder catheter and vaginal pack following vaginal prolapse surgery. ActaObstetGynecolScand.2007;86:1122–5.
Hakvoort RA, Elberink R, Vollebregt A, Ploeg T, Emanuel MH. How long urinary bladder catheterisation should be continued after vaginal prolapse surgery? A randomised controlled trial comparing short term versus long term catheterisation after vaginal prolapse surgery.BJOG.2004;111:828–30

Continence 2S2 (2022) 100236
DOI: 10.1016/j.cont.2022.100236