Duration of Urinary Catheterization Following Cesarean Deliveries Under Neuraxial Anesthesia (DUCC)

March 11, 2025 updated by: Anthony Chau, University of British Columbia

Duration of Urinary Catheterization Following Cesarean Deliveries Under Neuraxial Anesthesia: A Prospective Cohort Study

In cesarean deliveries, urinary catheters are often used to help empty the bladder while patients have limited mobility. These catheters typically stay in during early recovery because certain pain medications can make it hard for patients to urinate. Recently, the Society of Obstetric Anesthesia and Perinatology (SOAP) recommended removing catheters within 6-12 hours after delivery to aid recovery. However, at BC Women's Hospital, a review found that catheters stayed in for an average of 19 to 19.4 hours, even when patients were mobile.

Leaving catheters in too long can increase the risk of urinary tract infections (UTIs), pain, and urination issues, which can delay recovery and extend hospital stays. An internal review showed that factors like patient anxiety may affect when catheters are removed. Postpartum anxiety affects around 9.9% to 20.7% of new mothers in the first year and is an important factor in recovery after a cesarean delivery.

The main goal of this study is to look at how long urinary catheters stay in patients who had a cesarean delivery under spinal or epidural anesthesia, and what the score is from a questionnaire used to measure anxiety called the State Trait Anxiety Inventory (STAI-S), to see if there is a link between them.

Study Overview

Status

Not yet recruiting

Conditions

Detailed Description

This study aims to analyze how long foley catheters stay in the patient after their cesarean delivery under neuraxial anesthesia and what barriers there are in taking them out earlier.

Study Type

Observational

Enrollment (Estimated)

300

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Canada
    • British Columbia
      • Vancouver, British Columbia, Canada, V6H 3N1
        • BC Women's Hospital
        • Principal Investigator:
          • Anton Chau, MD MMSc
        • Contact:
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

Patient's who underwent a cesarean delivery at BC Women's Hospital.

Description

Inclusion Criteria:

  • Patients ≥19 years of age.
  • Undergoing cesarean delivery (elective or emergent) at BC Women's Hospital.
  • Neuraxial anesthesia as their primary mode of anesthesia (spinal, epidural, combined spinal-epidural, dural-puncture epidural).
  • In-patient status at 24 (+/- 8) hours.
  • Self-reported proficiency in speaking and reading English.

Exclusion Criteria:

  • Refusal to participate.
  • Inability to provide informed consent.
  • Other surgery (i.e. cervical cerclage) or delivery modes (i.e. operative vaginal delivery).
  • De novo general anesthetic, or patients who had a conversion from neuraxial to a general anesthetic.
  • Communication from patient's nurse indicating that it is not appropriate to approach due to distressing birth experience and/or outcome.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Correlation between duration of urinary catheterization and STAI-S score
Time Frame: From the time of enrollment until urinary catheter removal, assessed up to 24 (+/- 8) postpartum.
The STAI-S scale measures the respondents current state of anxiety by using terms to evaluate subjective feelings of worry, apprehension, concern, and nervousness. The scoring is 20-37 to indicate low anxiety, 38-44 to indicate moderate anxiety, and 45-80 to indicate high anxiety.
From the time of enrollment until urinary catheter removal, assessed up to 24 (+/- 8) postpartum.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Timing of delivery
Time Frame: From urinary catheter placement until its removal, assessed up to 24 (+/- 8) hours postpartum, categorized based on delivery time (e.g., morning: 06:00-11:59, afternoon: 12:00-17:59, evening/night: 18:00-05:59)
This outcome measures the duration of urinary catheterization in relation to the time of delivery. Specifically, it examines whether the time of day a patient delivers (e.g., morning vs. afternoon vs. evening/night) is associated with differences in the length of time the urinary catheter remains in place. The duration of catheterization will be recorded in hours from placement to removal and compared across delivery time categories
From urinary catheter placement until its removal, assessed up to 24 (+/- 8) hours postpartum, categorized based on delivery time (e.g., morning: 06:00-11:59, afternoon: 12:00-17:59, evening/night: 18:00-05:59)
Neuraxial Technique
Time Frame: From urinary catheter placement until its removal, assessed up 24 (+/- 8) hours postpartum, categorized by neuraxial technique used during delivery
This outcome measures the duration of urinary catheterization in relation to the neuraxial anesthesia technique used for delivery. Specifically, it examines whether different neuraxial techniques (e.g., spinal, epidural, combined spinal-epidural, or dural-puncture epidural) are associated with differences in the length of time the urinary catheter remains in place. The duration of catheterization will be recorded in hours from placement to removal and compared across neuraxial technique groups
From urinary catheter placement until its removal, assessed up 24 (+/- 8) hours postpartum, categorized by neuraxial technique used during delivery
Opioid Dose
Time Frame: From urinary catheter placement until its removal, assessed up to 24 (+/- 8) hours postpartum, categorized by total neuraxial opioid dose administered.
This outcome measures the duration of urinary catheterization in relation to the total opioid dose administered during neuraxial anesthesia for delivery. Specifically, it examines whether higher or lower opioid doses are associated with differences in the length of time the urinary catheter remains in place. The duration of catheterization will be recorded in hours from placement to removal and analyzed in relation to the opioid dose received during cesarean delivery. These opioid doses will be taken down: Total dose of spinal bupivacaine (mg), total dose of spinal fentanyl (mcg), total dose of spinal morphine (mg), total dose of epidural lidocaine (mg), total dose of epidural fentanyl (mcg), total dose of epidural morphine (mg).
From urinary catheter placement until its removal, assessed up to 24 (+/- 8) hours postpartum, categorized by total neuraxial opioid dose administered.
Nursing Perception
Time Frame: Survey completed by the patient's postpartum nurse within 24 (+/- 8) hours after urinary catheter removal.
This outcome measures postpartum nurses' perceptions of barriers to early urinary catheter removal. Nurses will complete a brief survey assessing nine predefined factors that may contribute to delayed catheter removal. Specifically, 'patient had difficulty mobilizing and/or voiding', 'patient had pain', 'patient was fatigued', 'patient experienced emotional and/or psychological distress', 'patient went to the NICU', 'patient requested to keep catheter in', 'patient had a history of infection (such as UTIs)', 'patient had a history of urinary retention', and 'concern about patient requiring re-catheterization'. Responses will be recorded as "Yes" or "No" for each statement, and the overall distribution of responses will be analyzed to identify common perceived barriers.
Survey completed by the patient's postpartum nurse within 24 (+/- 8) hours after urinary catheter removal.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of British Columbia

Investigators

  • Principal Investigator: Anton Chau, MD MMSc, University of British Columbia

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

April 25, 2025

Primary Completion (Estimated)

July 30, 2025

Study Completion (Estimated)

December 1, 2025

Study Registration Dates

First Submitted

February 13, 2025

First Submitted That Met QC Criteria

March 11, 2025

First Posted (Actual)

March 25, 2025

Study Record Updates

Last Update Posted (Actual)

March 25, 2025

Last Update Submitted That Met QC Criteria

March 11, 2025

Last Verified

March 1, 2025

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • H24-03410

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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