Optimal Duration Of Urinary Catheterization After Cesarean Delivery [17H]

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Abstract

INTRODUCTION:

Indwelling urinary catheter placement is the standard of care in cesarean deliveries. Studies have evaluated utilizing one-time catheterization preoperatively but no studies have investigated the ideal length of catheterization. The primary outcome was to compare rates of urinary retention in women undergoing cesarean delivery who have had their urinary catheter removed at 24 vs 12 hrs.

METHODS:

We performed a quality assurance, non-inferiority study. A survey assessed discomfort due to the catheter, time to first ambulation, and overall satisfaction. Demographic, operative and postoperative data was collected including information on re-catheterization for retention, time to first void after catheterization, pain scores, time to first ambulation, and length of stay.

RESULTS:

125 women had their catheters removed at 24 hours and 155 at 12 hours. Women in the 12 hour group took 30 minutes longer to void for the first time (3.0±1.6 vs. 3.6±1.9, p=0.002). More women in the 24 hour group (37.2% vs. 21.5%, p=0.004) would have preferred an earlier removed. Two women in the 12 hours group had urinary retention vs. 0 in the 24 hour group (p=0.2).

CONCLUSION:

There was no difference in the time to first ambulation, dysuria, or overall patient satisfaction. Earlier removal is associated with a clinically non-significant increase in time to first void and less desire for earlier removal. This study demonstrated no difference in urinary retention but a larger study would be needed to rule-out a less dramatic increase. Urinary catheterization greater than 12 hours seems to infer no medical benefits for women undergoing cesarean delivery.

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