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

Abstract

Background: There is no consensus on the preferred time to remove urethral catheter post caesarean section. Aim: To compare rate of significant bacteriuria and urinary retention following 8-h (study) and 24-h urethral catheter removal (control) post elective caesarean section. Methods: A randomized controlled trial of eligible participants that underwent elective caesarean section under spinal anaesthesia between March 2019 and November 2019 was conducted. Participants (150 in each arm) were randomly assigned (1:1 ratio) to either 8-h or 24-h group. Primary outcome measures included rates of significant bacteriuria 48-h post-operatively and acute urine retention 6-h post urethral catheter removal. Analysis was by Intention-to-treat. ( www.pactr.org:PACTR202105874744483 ) Results: There were 150 participants randomized into each arm and data collection was complete. Significant bacteriuria was less in 8-h group (3% versus 6.0%; risk ratio (RR): 0.85 CI: 0.60 to 5.66; p = 0.274), though not significant. Acute urinary retention requiring repeat catheterisation was significantly higher in 8-h group (11(7.3%) versus 0(0.0%); RR: 0.07; CI: 0.87 to 0.97; p = 0.001). Mean time until first voiding was slightly higher in 8-h group (211.4 ± 14.3 min versus 190.0 ± 18.3 min; mean difference (MD): 21.36; CI: −24.36 to 67.08; p = 0.203); but patient in this group had a lower mean time until ambulation (770.0 ± 26.1 min versus 809 ± 26.2 min; MD: −38.8; CI: −111.6 to 34.0; p = 0.300). The 8-h group were significantly more satisfied (82/150 (54.7%) versus 54/150 (36.0%); p = 0.001) Conclusions: An 8-h group was associated with significant clinical satisfaction and acute urine retention compared to 24-h removal. The timing of urethral catheter removal did not affect rate of significant bacteriuria and other outcomes

Management of Urinary Tract Infection in Pregnancy

“…Existe estudios clínicos aleatorizados que evalúan el tiempo para el retiro de la sonda vesical luego de la terminación del embarazo por parto por cesárea y comparan con el riesgo de desarrollar bateriuria, riesgo de infección urinaria, satisfacción de paciente y el tiempo del estancia hospitalaria hospitalaria, un estudio compara la retirada de la sonda a las dos y a las 12 horas; el otro compara la retirada de la sonda a las ocho y a las 24 horas. Se evidenció mayor riesgo de bacteriuria con el mayor tiempo de permanencia de la sonda vesical, pero ninguno de los estuidos confirmó mayor predisposición a infección del tracto urinaria, además el tiempo de estancia hospitalaria fue algo similar en ambos estudios [34,35].…”

The research frontier of cesarean section recovery: A bibliometric analysis

“…(4) Indwelling bladder catheter should be inserted before operation and maintained during operation; The bladder catheter should be removed preferentially within 12 h after CS; It is recommended to check for spontaneous urination within 4–6 h after removal of the bladder catheter. If the patient fails to empty within 6 h of extubation, the attending physician should be notified ( 19 – 21 ). (5) Patients are advised and encouraged to get out of bed as early as day 1 (or 6–8 h).…”

Efficacy and safety of different doses of epidural morphine coadministered with low-concentration ropivacaine after cesarean section: A retrospective cohort study

“…The primary outcomes included pain intensity at rest and movement and the incidence of urinary retention and pruritus within postoperative 48 h. Pain intensity was evaluated by using visual analog scale (VAS), with “0” representing no pain and “10” the worst pain ( Maged et al, 2018 ). Urinary retention was defined as the inability to void 6 h after urethral catheter removal that will require catheterization to obtain relief ( Igbodike et al, 2021 ). The pruritus severity of scalp was evaluated according to the VAS method ( Li et al, 2022 ).…”