# Self-Urinary Catheter Removal for Urology Day Cases: A Safe, Efficient, Sustainable, and Patient-Centred Approach

## TL;DR

This study shows that patients can safely remove urinary catheters at home after urology procedures, improving care and reducing healthcare costs and carbon emissions.

## Contribution

The study demonstrates the feasibility and benefits of self-catheter removal in urology day cases, contributing to patient-centered care and sustainability.

## Key findings

- All patients successfully removed their catheters at home without A&E visits for catheter-related issues within 30 days.
- Self-catheter removal increased same-day discharge rates for HoLEP procedures and reduced carbon emissions and travel costs.

## Abstract

Introduction

Urology day procedures need a significant proportion of patients to have an indwelling catheter for a substantial time post-procedure. Self-catheter removal offers better patient care for both patients and healthcare, while contributing to the sustainability goals of the National Health Service (NHS).

Patient and methods

This project has been used to remove a urethral catheter at home for patients who need a catheter after their surgery for over 12 hours and are expected to pass urine naturally post-catheter removal. From June 2024 to July 2025, 180 patients (average age: 63.1; range: 35-85) were included to carry out this retrospective audit, excluding those with post-procedural complications needing clinical supervision, frail patients, patients living alone, and patients unable to use the mobile application.

Results

In the study cohort, all patients were successful in removing their catheter at home and did not need to attend the accident and emergency (A&E) within 30 days for catheter-related issues. In the initial 44 patients, we analysed patient feedback, and 96% of the patients were happy to refer others for the service, with no reported difficulty related to catheter removal. This project improved same-day discharge rates from 41% (91 out of 220 patients) to 55% (150 out of 210 patients) for the Holmium Laser Enucleation of Prostate (HoLEP) procedure, saving about 1.7 tons of carbon emissions in total, while potentially saving 20.32£ of travel cost for hospital attendance per patient.

Conclusion

Although self-removal of a catheter is endorsed by standard practice in England, this study shows the appropriateness of the service for urology day cases, as there is a knowledge gap in the existing published reports. Also, suggest potential implications in other indications of catheter removal.