Efficacy of two Different Regimens Regarding Urinary Catheter Removal Time after Elective Cesarean Section: A Prospective Study

Abstract

Background: The proper time for removing the urinary catheter after caesarian section (CS) is still controversial and the decision of when to remove the catheter postoperatively is based on custom rather than evidence-based knowledge. Aim: To assess whether early (after 8 h) or delayed (after 24 h) removal of a urinary catheter after elective CS could affect, the rate of urinary retention with re-catheterization, rate of symptomatic urinary tract infections (UTI), ambula-tion time and hospital stay length. Materials& Methods: Prospective randomized trial conducted at obstetrics and gynecology department of Suez Canal University Hospitals. One hundred and fifty-one women underwent for term elective CS and were randomly allocated into two groups by simple randomization method. Women in group A (73 patients) had their urinary catheter removed 8 h post-operatively while in group B (67 patients) the catheter was removed after 24 h. The following outcomes were assessed: rate of re-catheterization, symptomatic UTI, ambula-tion time and hospital stay length. Results: Regarding the incidence of urinary retention and re-catheterization, patients in group A showed none significantly statistically difference when compared to patients in group B (2.7% versus 0% respectively). Delayed urinary catheter removal was associated with a higher incidence of UTI (16.4%), delayed ambulation time (11.3 h) and longer hospital stay (3.1days) compared to the early removal group (4.1%, 6.7 h and 1.8 days respectively). Conclusion: Removal of the urinary catheter 8h postoperatively appears to be more advantageous than late removal in cases of elective CS.