Comparing the Effects of Hot Pack and Lukewarm-Water-Soaked Gauze on Postoperative Urinary Retention; A Randomized Controlled Clinical Trial

Abstract

Background: Urinary retention is a common postoperative complication that mandates urinary catheterization. Urinary catheterization is associated with different physical, mental, and financial problems for both patients and healthcare systems. The patient inconvenience, urinary tract infections, and increase in hospital stay and expenses are common problems of urinary retention and urinary catheterization. Therefore, alternative ways of relieving urinary retention, preferably noninvasive interventions, are of great interest. Objectives: The aim of this study was to compare the effects of placing hot pack and lukewarm-water-soaked gauze on the suprapubic region on male patients with postoperative urinary retention. Patients and Methods:This was a three-group, randomized, controlled trial. A convenience sample of 126 male patients who had undergone general, orthopedic, or urologic surgeries were recruited. The block randomization method was used for allocating patients to either the two experimental groups (the hot pack and the lukewarm-water-soaked gauze groups) or the control one. Patients in the experimental groups were treated by placing either hot pack or lukewarm-water-soaked gauze on the suprapubic region. All patients were monitored for 20 minutes for urinary retention relief. If they did not experience urinary retention relief (starting urine flow and bladder evacuate), urinary catheterization would be performed. The data was collected using information sheet. Elimination of urinary retention was compared among study groups. The one-way analysis of variance and the Chi-square tests were used for analyzing data. Results: Respectively, 59.5%, 71.4%, and 7.1% of patients in the hot pack, the soaked gauze, and the control groups experienced relief from urinary retention and the bladder was emptied. There was a significant difference among study groups in percentage of patients who experienced urinary retention relief. However, the difference between the two experimental groups was not significant. The time to urinary retention relief in hot pack, soaked gauze, and control groups was 15.45 ± 3.15, 13.83 ± 3.80, and 14.59 ± 3.29 minutes, respectively. The difference among the study groups in time to urinary retention relief was not statistically significant. Conclusions: Both the lukewarm-water-soaked gauze and the hot pack techniques had significant effects on postoperative urinary retention and significantly reduced the need for urinary catheterization. Using these two simple and cost-effective techniques for managing postoperative urinary retention is recommended.

Systematic review of interventions for the prevention and treatment of postoperative urinary retention

“…High‐certainty evidence was found for a beneficial effect of applying a hot pack or gauze soaked in warm water to the suprapubic region (OR 0·04, 95 per cent c.i. 0·01 to 0·14; 1 trial). The same trial provided moderate certainty that there was no difference of effect between the two interventions.…”

“…After removal of duplicate records, 6415 reports were identified of which 48 studies (5644 participants) were included in the review ( Fig . ).…”

“…Eleven , , , , were judged at high risk of bias; these studies evaluated pharmacological (7 studies) and non‐pharmacological (3) interventions for the prevention of PO‐UR, and a pharmacological intervention (1 study) for the treatment of PO‐UR. There were 27 studies , , , , , , , rated as having some concerns; these studies evaluated pharmacological (16 studies) and non‐pharmacological (5) interventions for the prevention of PO‐UR, and pharmacological (2) and non‐pharmacological (4) interventions for treating PO‐UR.…”

Minimal Requirements in Reporting of Qualitative and Quantitative Studies: Critics on Two Papers

“…A reasonable explanation, of how the intervention under the investigation may serve, should be given, especially if there is little or no previous experience with the intervention ( 6 ). Afazel et al ( 5 ) did not present a reasonable explanation for conducting the comparison between a hot pack and lukewarm-water-soaked gauze, on urinary retention.…”

“…On December 2014, Afazel et al ( 5 ) have reported a clinical trial on comparing the effect of hot pack and lukewarm-water-soaked gauze on postoperative urinary retention. The importance of the issue and conducting a randomized clinical trial are among the strengths of this study, which are supported by an appropriate design.…”