Indwelling Bladder Catheter Using in Cesarean Section: Is It Really Necessary?

Öz

Aim: This study aimed to evaluate the safety of cesarean section (CS) without an indwelling bladder catheter. We also aimed to compare the differences of clinical and voiding characteristics in patients with or without the urinary catheter after CS. Materials and Methods: This case-control study was conducted retrospectively in Gazi University Faculty of Medicine Hospital between April and September 2021. A total of 40 patients having an elective CS were reviewed. Among these patients, two groups were analyzed according to urinary catheter use: Patients without the urinary catheter (Group 1 / Study) and patients with the urinary catheter (Group 2 / Control). Outcome measures were postoperative urination, postoperative mobilization, and the discharge time of the patients. Results: While cesarean duration was significantly longer in group 1, postoperative urination, postoperative mobilization, and the hospital discharge times were significantly longer in group 2 (p<0.05). Voiding discomfort rate and residual volume were similar between groups. There was no surgical complication during the operation in the two groups. Besides, urinary tract infection and bladder distention were not observed in both groups. Conclusion: Routine indwelling bladder catheter seems not obligatory in patients undergoing cesarean section. Although many clinicians still use these catheters to avoid surgical complications, indwelling urinary catheters might negatively affect postoperative mobilization, urination, and hospital discharge times. Cesarean delivery can be performed safely without the bladder catheter. Given the higher risk of the COVID-19 pandemic in prolonged hospital stays, no catheter insertion may be considered a suitable option.

Anahtar Kelimeler

• Cesarean Section
• Urinary Catheters
• Urination
• Urinary Bladder

Sezaryende Kullanılan Kalıcı Mesane Kateteri: Gerçekten Gerekli mi?

Öz

Amaç: Bu çalışma kalıcı mesane kateteri olmadan sezaryen doğumun (SD) güvenliğini değerlendirmeyi amaçlamıştır. Ayrıca bu çalışmada üriner kateteri olan ve olmayan hastaların SD sonrası klinik ve idrar boşaltım özellikleri arasındaki farklılıkların karşılaştırılması da amaçlanmıştır. Gereç ve yöntemler: Bu vaka-kontrol çalışması Gazi Üniversitesi Tıp Fakültesi Hastanesi'nde Nisan ile Eylül 2021 tarihleri arasında retrospektif olarak yürütüldü. Elektif sezaryen olan toplam 40 hasta incelendi. Bu hastalardan idrar sondası kullanımına göre iki grup incelendi: idrar sondası olmayan hastalar (Grup 1 / Çalışma) ve idrar sondası olan hastalar (Grup 2 / Kontol). Sonuç ölçütleri postoperatif idrara çıkma, postoperatif mobilizasyon ve hastaların taburcu olma süresi idi. Bulgular: Grup 1'de sezaryen süresi anlamlı olarak daha uzun iken, grup 2'de postoperatif idrara çıkma, postoperatif mobilizasyon ve hastaneden çıkış süreleri anlamlı olarak daha uzundu (p<0.05). İşeme rahatsızlık oranı ve rezidüel hacim gruplar arasında benzerdi. Her iki grupta da operasyon sırasında herhangi bir cerrahi komplikasyon gelişmedi. Ayrıca, çalışma popülasyonunda idrar yolu enfeksiyonu ve mesane distansiyonu gözlenmedi. Sonuç: Rutin kalıcı mesane kateteri sezaryene giden hastalarda zorunlu görünmemektedir. Birçok klinisyen cerrahi komplikasyonları önlemek için bu kateterleri kullanmaya devam etse de, ameliyat sonrası mobilizasyon, idrara çıkma ve hastaneden taburcu olma süreleri kalıcı idrar sondalarından olumsuz etkilenebilir. Sezaryen ile doğum, mesane kateteri olmadan da güvenle yapılabilir. Uzun hastanede kalışlarda COVID-19 pandemisinin daha yüksek riski göz önüne alındığında, bu yaklaşım uygun bir seçenek olarak kabul edilebilir.

Anahtar Kelimeler

• Sezaryen
• İdrar kataterleri
• İdrar yapma
• Mesane

Kaynakça

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