From the Guidelines
A Foley catheter can typically be removed within 24 hours after lithotripsy with stent placement, as recommended by recent guidelines 1. The exact timing depends on several factors including the complexity of the procedure, patient's recovery, and the surgeon's preference.
- Before removal, healthcare providers will ensure that urine is clear or only minimally bloody, pain is controlled, and there are no signs of infection.
- Patients should be able to drink adequate fluids and have normal bladder function before the catheter is removed.
- The Foley catheter is initially placed to ensure proper urinary drainage while swelling subsides and to monitor for bleeding or clots that might obstruct urine flow.
- Once these concerns are resolved, the catheter becomes unnecessary, and its removal is supported by a high grade of evidence and recommendation 1. Key considerations for removal include:
- The patient's ability to urinate normally
- The absence of complications such as infection or bleeding
- The patient's overall recovery and comfort level After Foley removal, patients should continue to drink plenty of fluids (2-3 liters daily) to help flush the urinary system and should be aware that the ureteral stent will remain in place for 1-2 weeks to maintain urinary drainage while the ureter heals, as part of a multimodal approach to care 1.
From the Research
Removal of Foley Catheter after Lithotripsy with Stent Placement
- The removal of a Foley catheter after lithotripsy with stent placement is a crucial aspect of patient care, as urinary catheters are associated with potential complications such as healthcare-associated infection and trauma to the neck of the bladder 2.
- There is no direct evidence in the provided studies that specifies the exact time frame for removing a Foley catheter after lithotripsy with stent placement.
- However, a study on early ureteral catheter removal after ureteroscopic lithotripsy using a ureteral access sheath found that early removal of postoperative ureteral catheterization can be safely performed for patients who undergo ureteroscopic lithotripsy with a ureteral access sheath 3.
- Another study suggests that routine placement of a ureteral stent is not mandatory in patients without complications after ureteroscopic lithotripsy for impacted ureteral stones, and stent placement can be argued and agreed upon with the patients preoperatively 4.
- The removal of a Foley catheter should be based on individual patient assessment, taking into account the presence of any complications or potential risks associated with the procedure 2, 5.