{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:28:49Z","timestamp":1787020129442,"version":"build-2736575974"},"reference-count":12,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The optimal duration of urinary catheterisation and the necessity of routine follow\u2010up cystogram prior to catheter removal in non\u2010iatrogenic bladder injury remain controversial. International guidelines vary, and no local protocol exists. This study reviewed our institutional experience to evaluate the yield of routine cystogram prior to catheter removal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective audit was conducted of patients with non\u2010iatrogenic bladder injuries managed at a Level 1 trauma centre between 2005 and 2024. Patients with partial thickness or complex injuries and those who died within 7\u2009days were excluded. Demographics, injury characteristics, management strategy, catheter duration, use of follow\u2010up cystogram and complications were analysed. Urinary tract infection was defined as a clinically diagnosed or microbiologically confirmed urinary infection documented during admission requiring antibiotic treatment. Intraperitoneal (IP) and extraperitoneal (EP) injuries were compared using non\u2010parametric and categorical statistical tests. Follow\u2010up cystography at our institution was performed using conventional fluoroscopic cystography. Contrast was instilled retrograde through an indwelling urethral catheter using diluted Omnipaque 350 in saline. The bladder was passively filled to approximately 300\u2013350\u2009mL, or until the patient reported fullness or resistance to filling was encountered. Standard anteroposterior and oblique radiographs were obtained. A positive cystogram was defined as any radiologically reported contrast extravasation consistent with a persistent urinary leak.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010two patients were included (53% male; median age 35\u2009years [IQR 26\u201353]). All included cases were attributable to blunt trauma. Eighteen (56%) injuries were IP and 14 (44%) EP. Twenty\u2010two (69%) injuries underwent operative repair. Thirty patients (94%) underwent routine follow\u2010up cystogram prior to catheter removal; all studies were normal. The median duration of catheterisation was 17\u2009days (IQR 11\u201325). Urinary tract infection occurred in 38% of patients. Patients who developed urinary tract infection had a longer median duration of catheterisation compared with those who did not develop urinary tract infection (27\u2009days [IQR 12\u201334] vs. 15\u2009days [IQR 10\u201322]). There were no urinary leaks identified following catheter removal and no mortality within the available follow\u2010up documentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Routine follow\u2010up cystogram prior to catheter removal demonstrated a very low diagnostic yield in uncomplicated non\u2010iatrogenic bladder injuries within our cohort. Prolonged catheterisation was common and associated with high rates of urinary tract infection. A selective approach to cystography and earlier catheter removal in uncomplicated injuries, particularly following IP repair, may be appropriate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70917","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:30:22Z","timestamp":1787016622000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Routine Cystogram Prior to Catheter Removal for Non\u2010Iatrogenic Bladder Injury May Not Be Necessary\u2014The Auckland City Hospital Experience"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2816-3026","authenticated-orcid":false,"given":"Nikilesh","family":"Babu","sequence":"first","affiliation":[{"name":"Department of Surgery University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9986-2764","authenticated-orcid":false,"given":"Lance","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Urology Auckland City Hospital  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2291-2572","authenticated-orcid":false,"given":"Victor","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Auckland  Auckland New Zealand"},{"name":"Department of Surgery Auckland City Hospital  Auckland New Zealand"},{"name":"Department of Surgery Chris Hani Baragwanath Hospital  Johannesburg South Africa"},{"name":"Department of Surgery University of KwaZulu\u2010Natal  Durban South Africa"},{"name":"Department of Surgical Sciences University of Stellenbosch  Cape Town South\u00a0Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7240-3604","authenticated-orcid":false,"given":"Daniel","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4953-8074","authenticated-orcid":false,"given":"Akash","family":"Boppana","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Auckland  Auckland New Zealand"},{"name":"Department of Surgery Auckland City Hospital  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9509-2275","authenticated-orcid":false,"given":"Joshua","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8467-1455","authenticated-orcid":false,"given":"Damian","family":"Clarke","sequence":"additional","affiliation":[{"name":"Department of Surgery University of KwaZulu\u2010Natal  Durban South Africa"},{"name":"Department of Surgery University of the Witwatersrand  Johannesburg South\u00a0Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Civil","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Auckland  Auckland New Zealand"},{"name":"Department of Surgery Auckland City Hospital  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"L. 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A.Lopez andB.Burns \u201cBladder Rupture \u201dStatPearls\u2014NCBI Bookshelf 2023 https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK470226\/."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.16236"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/ju.0000000000001408"},{"issue":"1","key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.eururo.2004.07.028","article-title":"EAU Guidelines on Urological Trauma","volume":"47","author":"Lynch T.","year":"2005","journal-title":"European Urology"},{"key":"e_1_2_9_6_1","unstructured":"L.KangandA.Geube \u201cBladder Trauma \u201dStatPearls\u2014NCBI Bookshelf 2023 https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK557875\/."},{"issue":"8","key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1016\/j.injury.2012.03.031","article-title":"Multi\u2010Disciplinary Update on Pelvic Fracture Associated Bladder and Urethral Injuries","volume":"43","author":"Figler B.","year":"2012","journal-title":"Injury"},{"key":"e_1_2_9_8_1","unstructured":"2024 Auckland City Hospital \u201cTrauma Registry Report \u201dcited September 30 2025 https:\/\/www.trauma.co.nz\/assets\/Uploads\/General\/Trauma\u2010Registry\u2010Report\u20102024.pdf."},{"issue":"1","key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1097\/01.ta.0000200096.44452.8a","article-title":"Cystogram Follow\u2010Up in the Management of Traumatic Bladder Disruption","volume":"60","author":"Inaba K.","year":"2006","journal-title":"Journal of Trauma"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15404"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017\u2010019\u20100274\u2010x"},{"issue":"2","key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1097\/TA.0000000000002132","article-title":"Management of Blunt Force Bladder Injuries","volume":"86","author":"Yeung L. L.","year":"2019","journal-title":"Journal of Trauma and Acute Care Surgery"},{"key":"e_1_2_9_13_1","unstructured":"Urological Trauma \u201cEAU Guidelines on Urological Trauma\u2014INTRODUCTION\u2014Uroweb \u201dhttps:\/\/uroweb.org\/guidelines\/urological\u2010trauma."}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70917","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.70917","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70917","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:30:29Z","timestamp":1787016629000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.70917"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":12,"alternative-id":["10.1111\/ans.70917"],"URL":"https:\/\/doi.org\/10.1111\/ans.70917","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]},"assertion":[{"value":"2026-02-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ans.70917"}}