Early versus delayed removal of indwelling catheters in patients after elective cesarean section: a prospective randomized trial

Abstract

Early removal of urinary catheters after elective cesarean section is associated with reduced mobilization time and hospital stay.

Effect of Lactobacillus plantarum Biofilms on the Adhesion of Escherichia coli to Urinary Tract Devices

“…Randomized controlled trials suggested that a removal time of the urinary catheter at ≤6 h postoperatively seems to be more beneficial than immediate or >6 h removal for patients undergoing gynecologic surgeries, decreasing both the ambulation time and hospital stay [73,74]. In fact, many clinical trials recommended the removal of urinary catheters within the first postoperative day (within a period ranging from 3 to 24 h) for many surgical interventions that do not require long catheterization periods, such as pelvic rectal or colorectal resection surgery, gynecological procedures (gynecological laparotomy, cesarean section, colposuspension, vaginal plastic surgery, vaginal prolapse surgery, and vaginal, laparoscopic or abdominal hysterectomy) or urological surgeries (transurethral resection of the prostate) [74][75][76][77][78][79][80][81][82][83]. For operative patients who have an indication for an indwelling catheter, the removal of the catheter should be done as soon as possible postoperatively, preferably within 24 h [84].…”

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

“…This urodynamic study may portend a better safety profile for the 8-h group; however, this has not been popularized clinically. 8 Interventions like non-urethral catheterization, 3 , 4 immediate removal, 7 2-h removal, 10 6-h removal, 11 , 12 and 24-h removal 1 , 7 after caesarean section are flawed with urine retention morbidity. Immediate or very early removal of urethral catheter may increase the risk of urine retention necessitating the need for recatheterization.…”

“…Immediate or very early removal of urethral catheter may increase the risk of urine retention necessitating the need for recatheterization. 4 , 10 , 12 There is currently no consensus on the specific time for removal of urinary catheter post caesarean section. 12 The more the duration of urethral catheter in the urinary bladder, the higher the significant bacteriuria rate and the less incidence of urinary retention following caesarean section under spinal anaesthesia.…”

“…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.…”

“… 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. In addition, the peculiar findings of Zanfini et al on 8-h urethral catheter removal in which almost 80% of patients who had caesarean section under spinal anaesthesia achieving urinary bladder function has not been investigated clinically in randomized clinical trials.…”