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

Yıl 2022, Cilt: 19 Sayı: 3, 1396 - 1400, 30.09.2022

Erhan Demirdağ , Munire Funda Cevher Akdulum , Esin Şahin Toruk , Recep Onur Karabacak

https://doi.org/10.38136/jgon.1066477

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

• 1. Hamilton BE, Martin JA, Osterman MJ, Curtin SC, Matthews TJ. Births: Final Data for 2014. National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System. 2015;64(12):1-64.
• 2. Ghoreishi J. Indwelling urinary catheters in cesarean delivery. Int J Gynaecol Obstet. 2003;83(3):267-70.
• 3. Beeson PB. The case against the catheter. Am J Med. 1958;24(1):1-3.
• 4. Pandey D, Mehta S, Grover A, Goel N. Indwelling Catheterization in Caesarean Section: Time To Retire It! J Clin Diagn Res. 2015;9(9):Qc01-4.
• 5. Nasr AM, ElBigawy AF, Abdelamid AE, Al-Khulaidi S, Al-Inany HG, Sayed EH. Evaluation of the use vs nonuse of urinary catheterization during cesarean delivery: a prospective, multicenter, randomized controlled trial. J Perinatol. 2009;29(6):416-21.
• 6. Buchholz NP, Daly-Grandeau E, Huber-Buchholz MM. Urological complications associated with caesarean section. Eur J Obstet Gynecol Reprod Biol. 1994;56(3):161-3.
• 7. Tangtrakul S, Taechaiya S, Suthutvoravut S, Linasmita V. Post-cesarean section urinary tract infection: a comparison between intermittent and indwelling catheterization. Journal of the Medical Association of Thailand = Chotmaihet thangphaet. 1994;77(5):244-8.
• 8. Chaudhuri P, Vengadasalam D. Urinary tract infection following abdominal delivery--second thought on indwelling catheter. Singapore Med J. 1983;24(4):224-6.
• 9. Moulton L, Lachiewicz M, Liu X, Goje O. Catheter-associated urinary tract infection (CAUTI) after term cesarean delivery: incidence and risk factors at a multi-center academic institution. J Matern Fetal Neonatal Med. 2018;31(3):395-400.
• 10. Schwartz MA, Wang CC, Eckert LO, Critchlow CW. Risk factors for urinary tract infection in the postpartum period. Am J Obstet Gynecol. 1999;181(3):547-53.
• 11. Barnes JS. Is it better to avoid urethral catheterization at hysterectomy and caesarean section? The Australian & New Zealand journal of obstetrics & gynaecology. 1998;38(3):315-6.
• 12. Weinstein JW, Mazon D, Pantelick E, Reagan-Cirincione P, Dembry LM, Hierholzer WJ, Jr. A decade of prevalence surveys in a tertiary-care center: trends in nosocomial infection rates, device utilization, and patient acuity. Infection control and hospital epidemiology. 1999;20(8):543-8.
• 13. Senanayake H. Elective cesarean section without urethral catheterization. J Obstet Gynaecol Res. 2005;31(1):32-7.
• 14. Betrán AP, Merialdi M, Lauer JA, Bing-Shun W, Thomas J, Van Look P, et al. Rates of caesarean section: analysis of global, regional and national estimates. Paediatric and perinatal epidemiology. 2007;21(2):98-113.
• 15. Bartzen PJ, Hafferty FW. Pelvic laparotomy without an indwelling catheter. A retrospective review of 949 cases. Am J Obstet Gynecol. 1987;156(6):1426-32.
• 16. Brumfitt W, Davies BI, Rosser EI. Urethral catherter as a cause of urinary-tract infection in pregnancy and puerperium. Lancet. 1961;2(7211):1059-62.
• 17. Acharya S, Uprety DK, Pokharel HP, Amatya R, Rai R. Cesarean section without urethral catheterization: a randomized control trial. Kathmandu University medical journal (KUMJ). 2012;10(38):18-22.
• 18. Onile TG, Kuti O, Orji EO, Ogunniyi SO. A prospective randomized clinical trial of urethral catheter removal following elective cesarean delivery. Int J Gynaecol Obstet. 2008;102(3):267-70.
• 19. Abdel-Aleem H, Aboelnasr MF, Jayousi TM, Habib FA. Indwelling bladder catheterisation as part of intraoperative and postoperative care for caesarean section. Cochrane Database Syst Rev. 2014(4):Cd010322.