Is bladder catheterization really necessary before laparoscopy?

A randomized prospective controlled trial compared a policy of bladder catheterization with no catheterization in patients undergoing laparoscopy. Of the 41 patients randomized to receive no catheterization, seven were actually catheterized on the judgement of the surgeon, but only one of them had greater than 50 ml of urine. Midstream urine obtained 6 days after laparoscopy was infected in 9 (21%) of the 42 patients allocated to receive catheterization and in only five (12%) of those allocated to the no-catheter group. Four of these five were actually not catheterized, giving an infection rate of 12% in the 34 patients not catheterized. The differences are statistically significant. A routine policy of catheterization for patients undergoing laparoscopy is questionable. All patients who are catheterized should be investigated for urinary tract infections after operation.