Summary of findings 2. Suprapubic catheterisation compared to intermittent self‐catheterisation for preventing bladder dysfunction after radical hysterectomy in women with early‐stage cervical cancer.
| Comparison 2: Suprapubic catheterisation versus intermittent self‐catheterisation | ||||||
| Patients: women with early‐stage cervical cancer Setting: tertiary hospital Intervention: suprapubic catheterisation (SPC) Comparison: intermittent self‐catheterisation (ISC) | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Assumed risk: suprapubic catheterisation | Corresponding risk: intermittent catheterisation | |||||
| Rate of spontaneous voiding recovery 1 week after surgery | ‐ | ‐ | ‐ | ‐ | ‐ | Not reported |
| Quality of life (QoL) | ‐ | ‐ | No differences of QoL between the comparison groups. See comment | ‐ | ‐ | Data were insufficient for calculating the relative measures |
| Time after surgery to post‐void residual volume of urine ≤ 50 mL (days) | ‐ | ‐ | ‐ | ‐ | ‐ | Not reported |
| Adverse events (acute complication after surgery) | 12 per 100 | 9 per 100 fewer (3 fewer to 30 more) | RR 0.77 (0.24 to 2.49) | 71 participants (1 RCT) | ⊕⊝⊝⊝ Very low a,b | 4 of 33 in SPC group versus 6 of 38 in ISC group |
| Post‐void residual urine volume (mL) at 1 month after surgery | ‐ | ‐ | ‐ | ‐ | ‐ | Not reported |
| Urinary tract infections in the first month after surgery | 35 per 100 | 27 per 100 (18 fewer to 39 more) | RR 0.77 (0.53 to 1.13) | 95 participants (2 RCTs) | ⊕⊝⊝⊝ Very low a,c |
Nwabineli 1993: 7 of 10 in SPC group versus 13 of 14 in ISC group Suprasert 2002: 8 of 33 in SPC group versus 11 of 38 in ISC group |
| Subjective urinary symptoms | ‐ | ‐ | No differences between the comparison group See comment | ‐ | ‐ | Available data were insufficient to calculate the relative measures of the effect of interventions. |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; MD: mean difference; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect | ||||||
aThe evidence was downgraded by two levels due to serious imprecision (small sample size and wide CI crossing the line of no effect). bThe evidence was downgraded by one level due to indirectness (reporting adverse events of unclear severity and unclear their association with the intervention). cThe evidence was downgraded by one level due to unclear risk of selection bias.