Indwelling Catheterization in Caesarean Section: Time To Retire It!

Abstract

Background: Routine placement of indwelling catheter preoperatively in Caesarean Section is being practiced without justified scientific evidence.

Aim: To evaluate the effect of routine indwelling catheterization on the postoperative ambulation, morbidity and hospital stay in women undergoing Caesarean section.

Settings and design: Case-Control study carried in a tertiary teaching hospital.

Materials and methods: This study was carried over 150 women undergoing primary Caesarean section without any medical complication or pre-existing Urinary Tract Infections (UTI). The subjects were randomly allocated to 2 groups i.e. Group 1(Non-Catheterized; NC) and Group 2 (Catheterized for 24 hours postoperatively; C). Parameters noted were; duration of surgery, time of ambulation, postoperative voiding discomfort {graded as - no, mild, moderate-severe, by Visual Analog Scoring (VAS)}, incidence of UTI, postoperative urinary retention, need of postoperative antibiotics and duration of hospital stay.

Statistical analysis: Results were analysed using unpaired t-test.

Results: There was no significant difference in duration of surgery and postoperative urinary retention in both groups. However, it was seen that non-catheterized patients had significantly earlier ambulation, shorter hospital stay, took less time for first voiding, lesser voiding discomfort, less incidence of UTI and lesser use of postoperative antibiotics.

Conclusion: The routine use of indwelling catheter in Caesarean section is unscientific and unnecessary. There should be selective rather than routine catheterization.

Keywords: Nosocomial infections; Urinary tract infection; Voiding discomfort.