Comparative Analysis of the Duration of Urethral Catheterization for Caesarian Delivery

Aims: To compare the effect of spontaneous voiding of urine to the different durations of the urethral catheter following elective caesarean section.

Study Design: Cross-sectional.

Place and Duration of Study: Department of Obstetrics and Gynaecology and department of microbiology, university of Port Harcourt Teaching Hospital, Port Harcourt between January and December 2014.

Methodology: We studied 160 booked parturient who had elective caesarean section. All the participants were randomly selected into three study groups and a control group. Each group consisted of 40 patients. The patients in control group voided spontaneously before and after surgery and did not have urethral catheterization. The study groups had urethral catheterization prior to surgery and were randomized into three groups of 40 patients depending on when their urethral catheters were removed postoperatively. All patients had mid-stream sample of urine collected a week prior to surgery and 72 hours after surgery for bacterial culture.

Results: The overall incidence of urinary tract infection following caesarean section in this study was 26.9%. There was a significantly lower incidence of urinary tract infection (3.1%) for group B women (with immediate catheter removal after caesarean section) when compared to the next group with the least incidence of urinary tract infection post operatively (P=. 02). Escherichia Coli was the commonest organism causing the urinary tract infection post operatively. The overall incidence of acute urinary retention was 13.8%. The need for catheterization after caesarean section (9.4%) was highest among women in group-A (spontaneous voiding before and after surgery).

Conclusion: Immediate postoperative removal of a urethral catheter after elective caesarean section was associated with a lower incidence of urinary tract infection. Spontaneous voiding without catheterization increases the risk of postoperative acute urinary retention and does not eliminate the risk of urinary tract infection following caesarean section.