An Editorial on Revolutionizing Urinary Care in Pakistan by Embracing the United Kingdom National Health Service Approach to Catheterisation Documentation and Trial Without Catheter

Abstract

This editorial highlights the importance of catheterisation documentation and the practice of trials without catheters in improving patient outcomes in Pakistan. Acute urinary retention, a major urological emergency, needs short-term catheter placement, with a trial without a catheter used globally to reduce catheter-associated urinary tract infections. This procedure, often enhanced by alpha-1 blockers, enables patients to regain continence and promotes micturition post-catheterisation, particularly useful following surgeries such as prostatectomy. However, trials without catheters remain underutilised in Pakistan, particularly outside urology departments, potentially leading to severe complications such as acute renal failure and urosepsis. Accurate documentation of catheterisation details, including catheter size, insertion time, clinical indications, and any complications, is paramount for minimising risks and improving continuity of care. A clinical audit led by Dr. Syed Haseeb Ullah Jan Bacha at Eastbourne District General Hospital highlighted critical gaps in catheterisation documentation, revealing lapses in recording crucial parameters like bladder scan volumes and staff names. Recommendations from the audit, including educational interventions and system improvements, necessitate the need for precise record-keeping, a practice standard in the United Kingdom but lacking in Pakistan. Introducing trial without catheter (TWOC) and documentation practices can elevate patient safety and foster a culture of continuous improvement in Pakistan’s healthcare system.