- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05611255
Comparison of Two Bladder Catheterization Strategies in Thoracic Surgery Patients With an Enhanced Recovery After Surgery (ERAS) (URICATHOR)
Comparison of Two Bladder Catheterization Strategies in Thoracic Surgery Patients With an Enhanced Recovery After Surgery (ERAS): Systematic Intermittent Catheterization Versus Bladder Scan Guided Catheterization in the Post Anesthesia Care Unit: a Prospective Randomized Double-blind Study
Study Overview
Status
Intervention / Treatment
Detailed Description
Acute urinary retention (AUR) is clinically defined by the presence of a bladder globe, with complete inability to urinate, sometimes associated with severe suprapubic abdominal pain. It is a urological emergency. An AUR can be complicated by acute renal failure, obstruction lifting syndrome (polyuria), a vacuo hematuria, or a slammed bladder (characterized by the presence of a post-void residue).
Systematic intermittent catheterization (SIC) allows monitoring of diuresis during the per- and post-operative period, and prevents the risk of AUR. It is associated with numerous disadvantages, such as the risk of infection (nosocomial urinary tract infection, bacteriuria, candiduria), which doubles after 2 days of catheterization, the risk of trauma (bleeding from the urethra, hematuria), the delay in mobilization and ambulation, and the psychological impact on the patients (dependence, agitation, confusion). All of these complications are potentially at risk of lengthening the average length of stay, and represent an additional cost for the Health Insurance. Thus, it seems that SIC is an obstacle to enhance recovery after surgery (ERAS), which is why the investigators have eliminated this option in our center. However, even recent American protocols for thoracic ERAS consider that an epidural should be associated with an indwelling catheter.
Bladder catheterization strategies are available for patients undergoing lung surgery. Options include no bladder catheterization, evacuation catheterization, and post anesthesia care unit catheterization guided by ultrasound or bladder scan measurement of bladder volume.
SIC is a strategy that involves draining urine once, in all patients, after surgery (in the operating room). Bladder Scan Guided Catheterization in the post anesthesia care unit (BSGC) is an innovative strategy that consists of a standardized and reproducible assessment of the bladder volume before discharge from the post anesthesia care unit, and draining urine only in patients who require it.
To their knowledge, no study has compared these two bladder catheterization strategies in a thoracic ERAS protocol.
The hypothesis is that a SIC strategy is superior to an individualized BSGC strategy in preventing postoperative AUR in thoracic surgery patients entering a ERAS program.
The SIC strategy is a novel idea that is not yet widely used in ERAS programs. The investigators believe that the SIC strategy will significantly decrease the rate of AUR. If this strategy proves to be superior to our current "bladder scan guided" service protocol, it could be incorporated into our ERAS program. Knowing the clinical repercussions, psychological impact, and costs associated with postoperative AUR, the medico-economic prospects of this study are major.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Jérôme PANIEGO, IADE
- Phone Number: +33 0664439476
- Email: j-paniego@chu-montpellier.fr
Study Contact Backup
- Name: Marc MOURAD, MD
- Email: m-mourad@chu-montpellier.fr
Study Locations
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-
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Montpellier, France, 34295
- Recruiting
- University Hospital of Montpellier
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Contact:
- Jérôme PANIEGO
- Phone Number: +33 0664439476
- Email: j-paniego@chu-montpellier.fr
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Undergoing scheduled thoracic surgery at the study center
- Be of legal age
- Be eligible for the enhanced recovery after surgery (ERAS) protocol in effect in the department.
Exclusion Criteria:
- Non-intubated anesthesia with spontaneous ventilation (NIVATS)
- Already have an indwelling bladder catheter or suprapubic catheter or double J catheter or other urinary drainage device
- Urinary tract infection under treatment or bladder catheterization less than one month old
- Indication of per- or postoperative bladder catheterization for another reason (e.g. monitoring of diuresis in chronic renal failure)
- Known vesico-sphincter disorder with documented post-void residue
- Neurological bladder (spinal cord injury or stroke sequelae)
- Documented urinary incontinence
- Chronic renal failure with a glomerular filtration rate (GFR) < 30 ml/min
- Contraindication to bladder catheterization (e.g. stenosis of the urethra)
- Be under legal protection or incapable of giving consent
- Failure to obtain written informed consent after a reflection period
- Not be affiliated to a French social security system or a beneficiary of such a system
- Long-term morphine drugs
- Pregnancy in progress or planned during the study period, Pregnant or nursing women
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Systematic Intermittent Catheterization (SIC)
A bladder catheter will be placed in the operating room, at the end of the operation, in a patient still under general anesthesia.
Once the urine has been drained and quantified, the bladder catheter will be removed before the patient is discharged and extubated.
|
A strategy that consists of draining urine only once, in all patients, after surgery (in the operating room).
Other Names:
|
Active Comparator: Bladder Scan Guided Catheterization (BSGC)
No systematic catheterization will be performed, the indication for catheterization will be guided by bladder-scan volume monitoring.
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A strategy of standardized and reproducible assessment of bladder volume before discharge from the post anesthesia care unit, and draining urine only in patients who require it.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Occurrence of acute urinary retention (AUR) within 24 hours postoperatively
Time Frame: 24 hours after thoracic surgery
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AUR is defined by the absence of voiding recovery in an unprobed patient, with or without pubic pain (pain may be inhibited by epidural or morphine received), associated with a bladder volume > 400 ml on bladder scan.
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24 hours after thoracic surgery
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Occurrence of acute urinary retention (AUR) after Day 1 and during the first 5 days after surgery or during the hospital stay
Time Frame: Between Day 1 and Day 5 postoperative
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Compare the rate of AUR occurring beyond the 24th postoperative hour between the two groups.
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Between Day 1 and Day 5 postoperative
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Bladder volume drained
Time Frame: The first hour after catheter placement
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Bladder volume drained the first hour after catheter placement
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The first hour after catheter placement
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Total duration of the first bladder catheterization
Time Frame: During the first bladder catheterization
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Total duration of the first bladder catheterization
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During the first bladder catheterization
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Total number of bladder catheterizations
Time Frame: During the 5 days of post-surgical hospitalization
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Total number of bladder catheterizations
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During the 5 days of post-surgical hospitalization
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The rate of complications related to catheterization
Time Frame: During the 5 days of post-surgical hospitalization
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Macroscopic hematuria, documented urinary tract infection, suspected urinary tract infection with probabilistic antibiotic treatment.
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During the 5 days of post-surgical hospitalization
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The rate of complications related to AUR
Time Frame: During the 5 days of post-surgical hospitalization
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Postoperative acute renal failure
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During the 5 days of post-surgical hospitalization
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Other postoperative complications
Time Frame: During the 5 days of post-surgical hospitalization
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Postoperative hypotension, nausea or vomiting.
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During the 5 days of post-surgical hospitalization
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Duration before putting in the chair (in hours)
Time Frame: During the 5 days of post-surgical hospitalization
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Duration before putting in the chair (in hours)
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During the 5 days of post-surgical hospitalization
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Duration before standing up (in hours)
Time Frame: During the 5 days of post-surgical hospitalization
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Duration before standing up (in hours)
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During the 5 days of post-surgical hospitalization
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Length of hospital stay
Time Frame: During the 5 days of post-surgical hospitalization
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Length of hospital stay
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During the 5 days of post-surgical hospitalization
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Estimated cost of stay
Time Frame: During the 5 days of post-surgical hospitalization
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Estimated cost of stay
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During the 5 days of post-surgical hospitalization
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Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- RECHMPL20_0461
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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