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Abdel-Aleem, H., et al
|Subject Keywords:||Indwelling bladder catheterisation, Intraoperative, Postoperative care, Women, Caesaren section (CS)|
Caesaren section (CS) has become the most common obstetric surgery, with one in three of pregnant women having a caesarean delivery. The use of urinary catheters (flexible elastic tube used to drain urine from the bladder) during and after CS is routinely used with caesarean delivery. Alleged benefits of using catheters include; maintains bladder drainage that may improve visualisation during surgery and minimise bladder injury, and less retention of urine after operation (inability to pass urine), but it could be associated with an increased incidence of urinary tract infection, urethral pain, voiding difficulties after removal of the catheter, delayed ambulation, and increased hospital stay.
This review is based on five studies involving 1065 women undergoing CS. The studies were of moderate quality. The included studies did not use this review's criteria for diagnosis for UTI, so there are no data for this primary outcome. When considering UTI, as defined by the trial authors, there were no clear differences between groups. There were no data relating to bladder injury during the CS (the review's other primary outcome).
Our analysis showed that the use of urinary catheter was associated with less retention of urine after CS. On the other hand, pain/discomfort due to catheterisation or at first voiding after CS, time to ambulate and hospital stay favoured non-use of urinary catheter. There was no difference in the incidence of uterine bleeding due to uterine atony (relaxation of the uterus) after the delivery.
The limited evidence in this review is based five trials of moderate quality and results should be considered in this context. There is not enough evidence to assess the routine use of indwelling bladder catheters in women undergoing CS. There is a need for more rigorous research on this topic and future trials should use a standardised criteria for the diagnosis of UTI and other common outcomes.
|Rights:||© The Cochrane Collaboration|
Abdel-Aleem, H., et al. (2014) Indwelling bladder catheterisation as part of intraoperative and postoperative care for caesarean section [Online]. Available from: http://www.thehealthwell.info/node/763415 [Accessed: 26th March 2017].