Female Urethral Catheterization

Ortega, Rafael; Ng, Linda; Sekhar, Pavan; Song, Michael

doi:10.1056/nejmvcm0706671

Cited by 22 publications

(14 citation statements)

References 3 publications

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“…15,16 Within 48 hours, up to 85% of indwelling catheters may be colonised with bacteria, which can lead to bacteriuria. 17 UTIs account for 40% of all nosocomial infections, and about 80% of these are associated with the use of urinary catheters. 18 UTIs may lead to local and systemic morbidity, as well as serious complications, such as septic shock, respiratory insufficiency, secondary bloodstream infection, fluid balance disorders, chronic renal insufficiency and death, and related increases in healthcare costs.…”

Section: Introductionmentioning

confidence: 99%

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Is routine indwelling catheterisation of the bladder for caesarean section necessary? A systematic review

Wen

Wang

et al. 2010

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

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Background Urinary catheterisation, which is associated with 80% of urinary tract infections (UTIs), is routinely performed prior to caesarean section without justification from the best available research evidence.Objectives To assess whether it is necessary to place indwelling urinary catheters routinely in caesarean section, and to determine the effects of this procedure on UTIs, urinary retention, intraoperative difficulties, operative complications, as well as other outcomes. Selection criteria Randomised controlled trials (RCTs) and nonrandomised controlled trials (NRCTs) comparing the use versus nonuse of indwelling urinary catheters in caesarean section were included.Data collection and analysis Two reviewers independently selected the studies and extracted the data. Results from the trials were combined to calculate relative risks (RRs) for dichotomous outcomes and mean differences (MDs) for continuous outcomes, with 95% confidence intervals (CIs).Main results Three trials (two RCTs and one NRCT) were included, involving a total of 1084 participants. Compared with the use of indwelling urinary catheters, nonuse had a significantly lower incidence of UTIs [RR 0.08; 95% CI 0.01, 0.64 (study design: RCT); RR 0.10; 95% CI 0.02, 0.57 (study design: NRCT)], a lower rate of discomfort at first voiding (RR 0.06; 95% CI 0.03, 0.12), less time until first voiding (MD -16.81; 95% CI -17.31, -16.31) and less time until ambulation (MD -6.01; 95% CI -6.68, -5.35); there were no statistically significant differences in the rate of urinary retention [RR 5.00; 95% CI 0.24, 103.18 (study design: RCT); RR 0.74; 95% CI 0.04, 15.18 (study design: NRCT)], operating time (MD -1.10; 95% CI -3.32, 1.12) and rate of intraoperative difficulties (RR 1.00; 95% CI -3.32, 1.12).Conclusions The nonuse of indwelling urinary catheters in caesarean section is associated with less UTIs and no increase in either urinary retention or intra-operative difficulties. Our results suggest that the routine use of indwelling urinary catheters for caesarean delivery in haemodynamically stable patients is not necessary, and can be harmful. However, better and larger randomised trials are needed to confirm these findings.

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Section: Introductionmentioning

confidence: 99%

“…[19][20][21][22][23] The best way to prevent complications is to avoid catheterisation whenever possible. 17,24 A few clinical trials have been performed comparing the safety and feasibility of urinary catheterisation use to nonuse during caesarean section. 6,25,26 However, these studies focused on different outcomes.…”

Section: Introductionmentioning

confidence: 99%

Is routine indwelling catheterisation of the bladder for caesarean section necessary? A systematic review

Wen

Wang

et al. 2010

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

View full text Add to dashboard Cite

show abstract

“…The appropriate caliber of the catheter is also important, so the use of the narrowest size that can be effective is recommended to minimize the risk of complications. Large‐caliber urinary catheters are those between 18 and 24 Fr, and they must be used only in patients who are at risk for obstruction of the lumen (Ortega et al., ).…”

Section: Discussionmentioning

confidence: 99%

“…Sizes 12, 14, and 16 Fr are indicated for men and 12 and 14 Fr for women (Addison et al., ). Large‐caliber catheters are those between 18 and 24 Fr and are used in patients with high risk for device obstruction, such as those with frank hematuria (Ortega et al., ).…”

Section: Discussionmentioning

confidence: 99%

“…The proposed risk factors were divided into internal and external factors. The internal risk factors were advanced age (Addison et al, 2012;Sèze et al, 2007;, latex allergy , constipation , inadequate liquid intake , obesity , pelvic organ anatomical variations Ortega et al, 2008;, impaired cognition Pomfret & Nazarko, 2006), detrusor-sphincter dyssynergia and spinal cord trauma , mental confusion (Pomfret & Nazarko, 2006), sedation (Gray, 2008), and deficient patient or caregiver knowledge about urinary catheter care . External risk factors were long-term use of urinary catheters Sèze et al, 2007;, need to use retention balloon insufflated with 30 ml or more (Elgammal, 2009;Geng et al, 2012;Head, 2006;Igawa et al, 2008;), need to use large-caliber urinary catheter (Head, 2006;Igawa et al, 2008;Ortega et al, 2008;, impossibility of securing the catheter Gray, 2008;Igawa et al, 2008;, and multiple and frequent catheterizations Kondo et al, 2007;.…”

Section: Elaboration Of Diagnosis and Consensus Validationmentioning

confidence: 99%

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