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MP41-16 URINARY CATHETER DURATION FOLLOWING URETERONEOCYSTOSTOMY: EFFECT ON SURGICAL OUTCOMES

INTRODUCTION AND OBJECTIVE: To assess postoperative outcomes of ureteroneocystostomy (UNC) in simple ureteral reimplant, psoas hitch, and boari bladder flap based on urinary catheter duration. We sought to compare outcomes of patients who underwent an open or robotic UNC for ureteral obstruction. METHODS: Retrospective review of 145 patients who underwent UNC between July 2012 and February 2019 was performed. Patients were divided based on catheter duration: 1-2 (group 0), 3-7 (group 1), and more than 7 days (group 2). Multiple variables were assessed, including peri-operative and post-operative outcomes, evidence of urine leak, catheter, stent, and drain duration, ClavienDindo (C-D) scores at key intervals, and readmission rates. RESULTS: Common complications include urinary tract infections, pyelonephritis, and pain control. C-D scores varied from 0.37 at hospital admission to 0.77 at 90-days. The average C-D score between intake and 90-day follow up was 0.57, approximately equal to the average score at 30-days across all patients. A catheter duration greater than 7 days was found to be associated with significantly higher C-D scores across all periods of observation and to be significantly different from both duration less than 7 days and the sample mean for each period. On average, each additional day with a catheter beyond 7 days was found to increase average C-D score by 20% of the standard deviation (approximately 0.015 points per day of duration), with the effect of catheter duration being most pronounced at 90-day follow-up. The effect of moving from a classification category of less than 7 days to more than 7 days serves to increase the average C-D score by 16%, with statistical significance achieved for our findings. CONCLUSIONS: Use of a urinary catheter is commonplace in reconstructive urological surgery. Our results show that a longer duration of an indwelling catheter adversely affects patient outcomes following UNC. We demonstrate an objective increase in the complication rate following indwelling catheter use, categorized by an increase in C-D score, which was observed to be most significant for patients who have a catheter for more than 7 days. Ultimately, the duration of an indwelling catheter can significantly affect long-term recovery by increasing the likelihood of complications beyond the immediate postoperative period. Source of Funding: None