OBJECTIVE: The purpose of this study was to compare the risk of significant bacteruria between clean intermittent self-catheterization (CISC) and suprapubic catheterization (SPC) after urogynecologic surgery. STUDY DESIGN: Patients were randomized to CISC or SPC. A urinalysis and patient satisfaction questionnaire were conducted on postoperative days 2 and 7. Urine culture was performed for positive urinalysis. Significant bacteruria was defined as > 100,000 cfu/mL. To detect a decrease in bacteruria risk from 25% to 10%, 113 subjects per group were needed with 80% power and alpha of 0.05. RESULTS: Of 248 randomized patients, 210 were included in the final analysis. The overall risk of bacteruria was 27% with no difference between SPC and CISC (31% vs 23%, P = .23). Patients reported more frustration (P = .01) and more difficulty (P = .003) using CISC. CONCLUSION: There was no difference in risk of significant bacteruria between CISC and SPC. Patients reported more frustration and difficulty with self-catheterization.