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MP23-06: A Randomized, Controlled Trial of Active vs. Passive Voiding Trials

Saturday, May 13
7:00 AM - 9:00 AM
Location: BCEC: Room 151

Presentation Authors: James Mills*, Nathan Shaw, Helen Hougen, Hannah Agard, Robert Case, Timothy McMurry, Noah Schenkman, Tracey Krupski, Charlottesville, VA

Introduction: There are national quality initiatives to prevent catheter-associated urinary tract infections (CAUTI) due to morbidity and cost. Differences between active and passive voiding trials have not been previously studied in the general hospitalized population. Active voiding trials entail filling the bladder with saline before catheter removal. Passive voiding trials involve the bladder filling with urine naturally after catheter removal. We assessed the effects of active vs passive voiding trials on time to hospital discharge and the rates of urinary tract infection (UTI) and urinary retention (UR).

Methods: In a single-center, single-blind, randomized, controlled trial, patients who had urethral catheter removal were randomized to a standardized active voiding trial or passive voiding trial. Patients undergoing urethral or bladder surgery were excluded. The outcomes of interest were the patient's time to hospital discharge after the catheter removal and the rates of UTI (defined by the National Surgical Quality Improvement Program criteria) and UR within 2 weeks of catheter removal. Logistic regression was used to identify risk factors for urinary retention.

Results: We enrolled 274 patients. Table 1 shows the differences in outcomes between active and passive voiding trials.

BPH (OR 5.3, p=0.007); neurological disease (OR 3.1, p=0.03); and admission to a neurosurgical ward (OR 3.6, p=0.009) were associated with increased urinary retention.

Conclusions: Patients in the active group had 64% fewer urinary tract infections than patients in the passive voiding trial group. Although patients in the active group voided nearly 3 hours sooner than patients in the passive group, there was no difference between the groups in time to hospital discharge. There was no difference in the rate of UR between the groups. BPH, neurological disease, and admission to a neurosurgical ward increased the odds of urinary retention.

Source Of Funding: None

James Mills, MD, MSCR

University of Virginia

Dr. James Mills is a resident physician in the Department of Urology at the University of Virginia Health System in Charlottesville, Virginia. After completing his undergraduate studies in biochemistry at Virginia Tech, he completed medical school as well as a master's degree in clinical research at the University of Virginia.

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