Outcomes of self-trial without catheter pathway following elective urological surgery

INTRODUCTION: Indwelling urinary catheters are used commonly following urological procedures. Catheters require monitoring and subsequent removal, often necessitating a return to hospital. We introduced a new self-trial without catheter (TWOC) pathway, allowing patients to remove their own catheters at home and eliminating the need for return to hospital. METHODS: Between February 2023 and March 2024, patients undergoing elective urological surgery at Southmead Hospital, Bristol were considered. Inclusion criteria were patients with a new catheter following elective urological surgery, without anticipated complex TWOC and the ability to carry out TWOC instructions. Patients received written information, direction to an online video and a demonstration before discharge. Patients were given a date to undergo early morning self-TWOC, followed by a late-morning telephone call from a urology specialist nurse to check outcomes. Patients who failed the self-TWOC were triaged for appropriate follow-up. RESULTS: Of 68 patients (56 men and 12 women), 58 (85%) had a successful self-TWOC. Seven (10%) patients failed their self-TWOC and three (4%) were withdrawn. A total of 1,402 miles of car travel were avoided, with an average of saving of 50 minutes travelling per patient. CONCLUSIONS: The self-TWOC pathway was adopted successfully by suitable patients, eliminated the need for hospital returns and reduced the need for specialist nurse time running hospital TWOC clinics.