Removal of catheter at midnight versus early morning: the patients' perspective.

BACKGROUND: With an increasing role of the patient as a partner in making a combined decision in care plan goals, it is important to identify the patient's perspective of the experience of removal of catheter (ROC). METHODS: A non-consecutive prospective randomized study was performed in 84 patients who underwent a transurethral resection of the prostate to determine the impact of midnight versus early-morning ROC on sleep deprivation, over all discomfort to the patient. RESULTS: There was no difference in the patient experience in both groups. We found a reduced frequency during the first 6 h of ROC at midnight. However, there was an increased incidence of sleep disturbances in this group. This may in part be due to an anxiety of urge incontinence and may be allayed by appropriate counselling. There was no delay in discharge of the patients in both groups. CONCLUSION: The patients must, therefore, be given the choice of ROC either at midnight or early morning, as the advantages of a reduced frequency must be correlated with an increased incidence of sleep disturbances.

The trends of vasectomy reversal in the forces.

A reversal of a vasectomy is required in about 3% of men who undergo vasectomy. We set out to examine the relationships between the age at which vasectomy was performed and the interval before subsequent reversal within the context of the armed forces. Thirty seven patients were identified from hospital records, as having undergone a reversal of vasectomy in the preceding two years, and thirty one sets of notes were available for inspection. Ages at vasectomy and at reversal were recorded and, where stated in the notes, if there had been a change in partner prior to the reversal request. Twelve (39%) men were under the age of thirty years at the time of their vasectomy, with a mean time to reversal of 4.4 years. Nineteen (61%) were over the age of thirty years at time of the vasectomy and their mean time to reversal was 7.2 years. Where recorded, the reason for requesting a reversal was a change in partner in 90% of men. Men who had their vasectomies before reaching the age of thirty were more likely to undergo reversal in a significantly shorter period of time when compared to those over thirty years. The disseminated criteria for vasectomy should be adhered to and appropriate preoperative counselling by surgeons may be useful.