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.
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.
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 Seven (10%) patients failed their self-TWOC and three (4%) were withdrawn.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.
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.
Annals of the Royal College of Surgeons of England. 2026 Apr 16 [Epub ahead of print]
H Louden, T Minto, E Otto, B Plenty, H Burden, J Voss
North Bristol NHS Foundation Trust, UK.