Comparison of Two Bladder Catheterization Strategies in Thoracic Surgery Patients With an Enhanced Recovery After Surgery (ERAS)

General anesthesia, thoracic epidural, and morphine inhibit the urination process and promote postoperative Acute Urinary Retention (AUR) after thoracic surgery. Indwelling bladder catheterization prevents this risk, but is associated with other complications (urinary tract infection, delayed mobilization). With the rise of enhanced recovery after surgery (ERAS) protocols, bladder catheterization is being questioned. The current protocol in the department is to catheterize only patients with a high bladder volume in the post anesthesia care unit (defined as a bladder volume > 400 ml on bladder scan). Preliminary results from the "AirLeaks" study show a high rate of early postoperative AUR (approximately 50%). The investigators believe that a "systematic intermittent catheterization" (SIC) strategy is superior to the current "bladder scan-guided catheterization in the post anesthesia care unit" (BSGC) strategy in preventing the risk of postoperative AUR. To their knowledge, no study has compared these two bladder catheterization strategies in a thoracic accelerated rehabilitation protocol.

Inclusion Criteria:Undergoing scheduled thoracic surgery at the study centerBe of legal ageBe eligible for the enhanced recovery after surgery (ERAS) protocol in effect in the department.Exclusion Criteria:Non-intubated anesthesia with spontaneous ventilation (NIVATS)Already have an indwelling bladder catheter or suprapubic catheter or double J catheter or other urinary drainage deviceUrinary tract infection under treatment or bladder catheterization less than one month oldIndication of per- or postoperative bladder catheterization for another reason (e.g. monitoring of diuresis in chronic renal failure)Known vesico-sphincter disorder with documented post-void residueNeurological bladder (spinal cord injury or stroke sequelae)Documented urinary incontinenceChronic renal failure with a glomerular filtration rate (GFR) < 30 ml/minContraindication to bladder catheterization (e.g. stenosis of the urethra)Be under legal protection or incapable of giving consentFailure to obtain written informed consent after a reflection periodNot be affiliated to a French social security system or a beneficiary of such a systemLong-term morphine drugsPregnancy in progress or planned during the study period, Pregnant or nursing women