Caesarean Section Without Using Bladder Catheterization Is Safe in Uncomplicated Patients

Abstract

A case -control study was carried out to assess whether carrying out caesarean section without urethral catheterization is safe in terms of intraoperative safety, prevalence of UTI, and the rate of the first voiding discomfort. It was conducted At Al Thawra General Hospital over a period of eight months (From Feb 1 st to Sep 30 th 2015). One hundred women who admitted to delivery unit and delivered by cesarean section were enrolled in the study. They were divided randomly into study group (non catheterized, n = 50) and control group (catheterized, n = 50). There were no significant differences between the study and control group regarding maternal age, parity and the indications for cesarean section. Of the study group, only one women developed bladder distension at the end of surgery. First voiding discomfort was detected among 86% of the control group vs. 50% of the study cases (P < 0.05). The mean time till ambulation was 8.2 ± 2.1 h for the study group compared to 14.1 ± 2.9 h for the control group (P < 0.001). Urinary tract infection was significantly higher among the control group (28%) vs (8%) of the study cases (P= 0.009). This study showed that nonuse of urinary catheter during cesarean section is associated with significantly low rate of UTI, less first voiding discomfort and early ambulation. Therefore, urinary catheter can be avoided safely in hemodynamecally stable patients.

Eight-hour versus 24-h urethral catheter removal following elective caesarean section for reducing significant bacteriuria: A randomized controlled trial

“…Removing the urethral catheter earlier may reduce the incidence of significant bacteriuria, encourage early ambulation, and may shorten the hospital stay post caesarean delivery. 3 , 4 , 6 , 7 , 10 The policy of 8-h urethral catheter removal post surgery may encourage post-operative patients to get off the hospital bed and micturate by themselves, thus achieving early mobilization which discourages the formation of deep venous thrombosis. 10 There is lack of evidence on the use of 8-h urethral catheter removal post caesarean section.…”

“…1,4 The advocacy for elective caesarean delivery under spinal anaesthesia rather than general anaesthesia revolves around reduced morbidity and mortality risks associated with spinal anaesthesia. [5][6][7] Spinal anaesthesia may, however, affect the lower urinary tract innervation 8,9 and leading to a delay in the time of first voiding and ultimately urinary retention with prevalence ranging from 0.05% to 14.1%, following vaginal delivery, and between 3.3% and 24.1% after caesarean delivery. 4 Zanfini et al 8 showed that up to 80% of urinary bladder function is regained 8 h following spinal anaesthesia.…”