Reducing Late-Night Urology Referrals Through Structured Difficult Catheterization Training for General Surgery Residents and Nurses: A Prospective Interventional Study

Patil A1, Kamble A1, Potdar O1, Sharma S1

Research Type

Clinical

Abstract Category

Urethra Male / Female

Abstract 659
Open Discussion ePosters
Scientific Open Discussion Session 108
Saturday 20th September 2025
13:30 - 13:35 (ePoster Station 1)
Exhibition
Prospective Study Male Prevention
1. Grant Government Medical College and Sir J.J. Group of Hospitals
Presenter
A

Ashay Arun Patil
Grant Government Medical College and Sir J.J. Group of Hospitals
Links

Abstract

Hypothesis / aims of study 
Difficult urethral catheterization (DUC) is a common challenge in clinical practice, leading to multiple failed attempts, urethral trauma, and unnecessary late-night urology referrals. General surgery residents and nursing staff often lack structured training in managing DUC, increasing the risk of complications. This study evaluates the impact of a structured training program on reducing late-night urology referrals and improving catheterization success rates.
Study design, materials and methods 
A prospective interventional study was conducted at a tertiary care hospital from July 2024 to December 2024, divided into pre-intervention (July–September), intervention (October), and post-intervention (November–December) phases. The intervention consisted of hands-on training for general surgery residents and nurses on techniques such as the use of Coudé catheters, filiform and followers, and emergency suprapubic catheterization. Data on late-night referrals, successful catheterization attempts, and complications were compared before and after training.
Results 
A total of 152 cases of DUC were analyzed.
	•	Pre-intervention: 84 late-night referrals (28/month).
	•	Post-intervention: 33 late-night referrals (11/month), a 60.7% reduction (p < 0.001).
	•	Successful catheterization by non-urology residents increased from 31.0% (26/84 cases) to 78.8% (26/33 cases) (p < 0.001).
	•	Urethral trauma rates decreased from 19.04% (16/84 cases) to 6.06% (2/33 cases) (p = 0.02).
Interpretation of results 
The significant reduction in late-night urology referrals (60.7% decrease, p < 0.001) and improvement in successful catheterization rates by non-urology residents (31.0% to 78.8%, p < 0.001) indicate that structured training effectively enhances competence in difficult catheterization. Additionally, the decrease in urethral trauma rates (19.04% to 6.06%, p = 0.02) suggests that training minimizes unnecessary repeated attempts, improving patient safety. These findings support integrating difficult catheterization training into surgical and nursing education to optimize hospital workflow and reduce urology department burden.
Concluding message 
A structured training program significantly reduced late-night urology referrals and catheterization-related complications. Implementing similar educational interventions in surgical residency and nursing curricula can enhance patient care, prevent unnecessary delays, and optimize urology department workload.
Figure 1 Reduction in late night referrals
Figure 2 Improvement in catheterisation success rates
Figure 3 Reduction in urethral trauma rates
References 
  1. Osman NI, Mangera A, Chapple CR. Effect of training on urethral catheterization injuries: a prospective audit. Can Urol Assoc J. 2017;11(7):E302-E306. DOI: 10.5489/cuaj.4271
  2. Osman NI, Mangera A, Inman RD, et al. Medical interns’ knowledge of urethral catheterization and injury risk. BMC Med Educ. 2011;11:73. DOI: 10.1186/1472-6920-11-73
  3. Kidd AG, McLeod N, Sohlberg EM. Knowledge and confidence in urinary catheterization among healthcare staff. Can Urol Assoc J. 2021;15(6):E332-E337. DOI: 10.5489/cuaj.6986
Disclosures
Funding None Clinical Trial No Subjects Human Ethics Committee Institutional Ethics Committee, Grant Government Medical college and sir J.J. Group of Hospitals Helsinki Yes Informed Consent Yes
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