Safety and benefits of early urethral catheter removal after resectioning the recto urethral fistula during posterior sagittal anorectoplasty

Aims: A urethral catheter must be placed before PSARP (Posterior Sagittal Anorectoplasty) is performed on boys with recto-urethral fistula. However, there is no agreement on when the catheter should be removed. Surgeons usually keep the catheter for more than weeks, which is uncomfortable for patients. This study assesses the advantages and safety of removing the catheter early after PSARP. Methods: We have divided the patents into two groups. In Group 1, patients underwent PSARP with resection of RUF from January 2017 to February 2021, and the urethral catheter was kept for 14 days. In Group 2, patients were operated on between March 2021 and July 2023, and the urethral catheter was removed on the second day after the operation. The two groups ' demographic and clinical variables were compared using SPSS version 26. Outcome variables were post-operative urinary retention, difficulty in micturition, catheter blockage or dislodgement, fistula recurrence, hospital stay duration, and antibiotic therapy duration. Results: No patients in either group had urinary retention, recurrence of fistula, or lower urinary complication. However, postoperative hospital stay and antibiotic therapy significantly reduced from 11.2±2.3 days in Group 1 to 4.1±0.5 days in Group 2 (p<0.01). Conclusion: Early catheter removal after PSARP is safe, improves patient comfort, and reduces unnecessary hospital stays and antibiotic therapy.