Is It Better To Avoid Urethral Catheterization at Hysterectomy and Caesarean Section?

Barnes, John S.

doi:10.1111/j.1479-828x.1998.tb03074.x

Cited by 18 publications

(5 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The catheter is usually removed immediately after surgery, or 12–24 hours or more after surgery to avoid postoperative urinary retention 7–13 . The reported incidence rates of urinary retention after caesarean section vary from 3.3 to 39.2%, depending on the definitions used, 11,14 and catheterisation has been consistently associated with urinary tract infections (UTIs) 15,16 . Within 48 hours, up to 85% of indwelling catheters may be colonised with bacteria, which can lead to bacteriuria 17 .…”

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

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.

show abstract

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

“…As well as being uncomfortable, instrumentation of the bladder can cause urethral trauma and introduce bacteria into the urinary tract 3–8 . In our historical cohort of 40 patients undergoing comparable procedures who were routinely catheterized perioperatively, the rate of urinary tract infection was 1:8.…”

Section: Discussionmentioning

confidence: 92%

“…It has been demonstrated that for simple procedures, such as diagnostic laparoscopy or laparoscopic sterilization, elective catheterization is unnecessary and may be associated with an increased risk of urinary tract infection 3, 4 . A recent review concluded that the risk of developing a urinary tract infection was 3–10% per day following bladder catheterization; other studies have found rates as high as 20% during the first 24 h 5–7 . Catheterization may also lead to urethral trauma 8…”

Section: Introductionmentioning

confidence: 99%

Do not catheterize the bladder at operative laparoscopy

et al. 2001

View full text Add to dashboard Cite

Objective Bladder catheterization at operative laparoscopy is currently routine, although this may be associated with an increased risk of urinary tract infection and urethral trauma. We wanted to establish whether non‐catheterization is practical or whether it results in problems with operative view or postoperative urinary retention. Design Prospective study with historical controls. Setting Minimal‐access surgery unit at a tertiary referral centre. Subjects 40 consecutive women undergoing operative gynaecological laparoscopy. Interventions Patients were only catheterized intraoperatively if bladder filling interfered with surgery, or postoperatively if they failed to pass urine within 6 h. The rate of urinary infection was compared with 40 historical controls who were routinely catheterized. Results There were no cases of intraoperative bladder trauma. In total, five patients (12.5%) required a urinary catheter, three intraoperatively and two postoperatively. The likelihood of catheterization was significantly associated with an operating time >100 min (P < 0.01). One woman (2.5%), who was not catheterized had positive urine microbiology findings compared with five (12.5%) in the control group (P = 0.2). Although this was not statistically significant, this was not the main aim of our study. In fact, a total of 160 patients would be required to confirm a reduction in infection by 10%. Conclusions Bladder catheterization should not be routine prior to operative laparoscopy. Not only can most procedures be completed without catheterization, but it is likely that the risk of urinary infection would be reduced and there would be cost savings to the hospital.

show abstract

“…Urinary catheterization is a commonly used perioperative procedure in CS aiming to decompress the UB, improve the exposure of the lower uterine segment, decrease the incidence of UB injury, and prevent POUR [22] , however, some obstetricians prefer non-use of urinary catheter in CS aiming to lower the risk of urinary tract infection [23][24][25] . If an indwelling urinary catheter is used in CS, the removal of the catheter in the uncomplicated cases may be early (immediately or within 2 hours after CS) or delayed (12-24 hours after CS).…”

Section: Discussionmentioning

confidence: 99%

Intramuscular Neostigmine for Accelerating Bladder Emptying after Cesarean Section by Spinal Anesthesia

Aljaml,

Elnegery,

Shams-Eldien

et al. 2023

Evidence Based Women's Health Journal

View full text Add to dashboard Cite

Objective: To assess the efficacy of intramuscular (IM) neostigmine administration for acceleration of urinary bladder (UB) emptying and prevention of postoperative urine retention (POUR) following cesarean section (CS) performed under spinal anesthesia. Patients and Methods: Randomized controlled trial conducted on pregnant women who were planned to undergo elective CS under spinal anesthesia. All participants were randomly allocated after surgery into 2 groups; neostigmine group who received 0.5 mg IM neostigmine, and placebo group who received IM NaCl 0.9%. The primary outcome measures were time to first voiding after treatment and time to first voiding after catheter removal, and the secondary outcome measures were volume of excreted urine, postvoid residual bladder volume (PVRBV) and catheterization rate. Results: A total of 100 women (50 women in each group) were subjected to final analysis. Time to first voiding after treatment was significantly lower in neostigmine group than in placebo group (266.94 ± 77.53 vs 303.72 ± 64.07 min; P = 0.027). Also, time to first voiding after catheter removal was significantly lower in neostigmine group than in placebo group (214.90 ± 66.53 vs 241.60 ± 61.73 min; P = 0.036). However, there were no significant difference between both groups in volume of excreted urine, PVRBV and catheterization rate. Conclusion: IM injection of neostigmine can effectively accelerate UB emptying following CS under spinal anesthesia but it does not appear to decrease PVRBV or catheterization rate.

show abstract

Is It Better To Avoid Urethral Catheterization at Hysterectomy and Caesarean Section?

Cited by 18 publications

References 4 publications

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

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

Do not catheterize the bladder at operative laparoscopy

Intramuscular Neostigmine for Accelerating Bladder Emptying after Cesarean Section by Spinal Anesthesia

Contact Info

Product

Resources

About