Sacral Region Massage as an Alternative to the Urinary Catheter Used to Prevent Urinary Retention after Cesarean Delivery

Abstract

IntroductionUrinary retention is failure to void in the postoperative period even though the urinary bladder is full. Urinary retention, which can be seen in the early postoperative period (the first 6-8 hours), is a general complication that can also be seen in patients who do not have known urinary complaints. Many factors play a role in the development of postoperative urinary retention. Although age is accepted as the general precipitating factor, long surgical procedures, the surgical site, and pain can also lead to postoperative urinary retention (1-5).Urinary retention is seen most often after anterior abdominal wall and anorectal area operations. A cesarean section is an anterior abdominal wall operation. A urinary catheter may be inserted after abdominoperineal operations if there is a likelihood that urinary bladder functions will be impaired due to operation trauma in the sacral plexus. In our country urinary catheters are routinely inserted in patients before they undergo cesarean delivery, and they are removed shortly after surgery.The literature has reported various methods to encourage voiding after surgery. These have included voiding in a sitting position; early ambulation; providing a bedpan; listening to the sound of water; pouring warm water onto the pelvic area; applying pressure on the urinary bladder in the form of a hand massage; pelvic floor exercises (the kegel exercise); and providing diuretic drinks such as tea and coffee. All of these have been reported as treatments for urinary retention in patients who were unable to urinate after urinary catheter removal (2, 4). Despite the risk of infection, catheterization has also been recommended when micturition has not been achieved after all noninvasive methods have been tried (6, 7).As mentioned earlier, acute urinary retention is an inability to empty the bladder despite being full, and this complication frequently occurs during the postoperative period. Nurses are able to evaluate the presence of urinary retention, monitor the volume and excessive relaxation of the bladder and avoid unnecessary catheterizations (2-4). The association between urinary catheterization and urinary tract infection is well documented in the literature (5-7).Genitourinary infection is one of the most common complications (1.7 per 1000) of cesarean deliveries (6). One of the preoperative preparations for cesarean section is the placement of a foley catheter. However, bladder catheterization ABSTRACTObjective: The aim of the study was to determine the effect of massage to the sacral region after cesarean delivery instead of employing a urinary catheter for the prevention of urinary retention.Study Design: Cross sectional study. Material and Methods:This interventional study population consisted of 60 women who were divided into two intervention groups and one control group. For the first intervention group, the sacral region was massaged every hour 10-15 minutes after cesarean delivery and every 30 minutes after a voiding sensation for the second intervention gr...

Comparison of the effect of hot and cold compresses on post‐operative urinary retention in older patients: A clinical trial study

“…In this study, patients in both interventions groups experienced urinary retention for ~5 h after surgery. In the study by Dal, Umran, et al, which examined the sacral area massage to relieve urinary retention after caesarean section, the average duration of urinary retention was reported between 5 and 6 h after surgery, 16 despite the age difference between patients in two studies, is consistent with the present study.…”

“…15 Using noninvasive and safe nursing interventions to control and prevent postoperative urinary retention can minimise the need for catheterization. These interventions include massaging the patient's sacral area, 16 sitting in a pelvis of warm water, 17 reflective massage of the sole of the foot, 18 and the use of gas moistened with lukewarm water in the upper pubic area to relieve retention. 19 A review of the literature shows that many studies use warm compresses to relieve urinary retention, and some researchers have recommended its use.…”