A comparison between intermittent self-catheterization and transurethral indwelling catheterization in patients who underwent radical hysterectomy for cervical cancer: a systematic review

Voiding function recovery (VFR) is important in patients with cervical cancer who have undergone radical hysterectomy. However, there is no consensus about the optimal method of catheterization to enable VFR after surgery. This review compared intermittent self-catheterization (ISC) with transurethral indwelling catheterization (TIC) to identify the optimal method for VFR after radical hysterectomy for cervical cancer. We used the terms “cervical cancer AND ((indwelling catheterization) OR (intermittent self-catheterization))” to search PubMed, the Cochrane Library, and Embase from inception to July 2017. All trials involving ISC or TIC after radical hysterectomy for cervical cancer with reported time to VFR time were included. Seven studies with a total number of 581 patients were enrolled in this review. The time to VFR using ISC ranged from 6.5 to 17 days, with 3.5 to 14.8 days for TIC. The time to first removal of a postoperative indwelling catheter and assessment of post-void residual (PVR) urine volume was 3 to 8 days for ISC and 7 to 14 days for TIC. We concluded that these results were insufficient for a comparison between ISC and TIC in patients who underwent radical hysterectomy for cervical cancer. Further high-quality studies focusing on this topic are still needed. A worldwide effort to standardize catheterization after radical hysterectomy for cervical cancer is also recommended.