Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
Effects of Urinary Catheter Clamping After Cesarean Section on Urinary Retention and Urinary Tract Infection
Sezaryen Sonrası Üriner Kateter Klemplemenin Üriner Retansiyon ve İdrar Yolu Enfeksiyonu Üzerine Etkileri
Derya KANZA GÜLa
aClinic of Gynecology and Obstetrics, İstanbul Medipol University Faculty of Medicine, Nisa Hospital, İstanbul, TURKEY
J Reconstr Urol. 2020;10(2):35-43
doi: 10.5336/urology.2020-75010
Article Language: EN
Full Text
ABSTRACT
Objective: This study was planned to investigate the effect of intermittent clamping of the urinary catheter after cesarean section and exercising the detrusor muscle on the post-void residual urine volume and reduction of the risk of urinary tract infection in the early stage. Material and Methods: This randomized controlled study was carried out with 100 primiparous pregnant women who were to undergo elective cesarean section between January 2019 and January 2020. The participants were randomly assigned into 2 groups: the experimental group including 50 patients who underwent urinary catheter clamping 3 times after the postoperative 3rd hour, by turning off the urinary catheter for 3 hours, and then turning it on for 5 minutes and the control group including 50 patients who did not undergo urinary catheter clamping. The study data were collected with the maternal information form and Urinary Distress Inventory (UDI-6). The UDI-6 was used to assess the subjective voiding difficulty. The primary outcome of the present study was to determine whether exercising the detrusor muscle decreased post-void residual urine volume in patients having undergone cesarean section. The secondary results were the incidence of urinary tract infections and subjective symptoms experienced by the patients. Results: According to the comparison of the post-void residual urine volume in the experimental (E) and control (C) groups, no significant difference was observed between the groups on the first day [E=10 (20%), C=12 (24%) (p=0.629)] and in the first week [E=2 (4%), C=3 (6%) (p=1.000)]. In the sixth week, no post-void residual urine volume was observed in any patient in either group. There was no statistical difference between the groups in percentage change values in time dependent intragroup UDI-6 scores (p=0.453). While the median change in the experimental group was 50.60%, this value was obtained as 58.93% in the control group. While the rate of the participants with positive urine culture in the experimental group was 6%, it was 4% in the control group, and there was no significant difference between the groups (p=1.000). Conclusion: In our study, urinary catheter clamping has no reducing effect on post-void residual urine volume, urinary tract infection and subjective voiding difficulty.

Keywords: Bladder exercising; urinary catheter clamping; urinary retention; cesarean section
ÖZET
Amaç: Bu çalışma, sezaryen sonrası idrar sondasının aralıklı olarak klemplenmesi ve detrusor kasının egzersizinin rezidüel idrar hacmi üzerine ve erken evrede idrar yolu enfeksiyonu riskini azaltmada etkisini araştırmak için planlandı. Gereç ve Yöntemler: Bu randomize kontrollü çalışma, Ocak 2019-Ocak 2020 tarihleri arasında elektif sezaryen ameliyatı geçirecek olan 100 primipar gebe kadınla gerçekleştirildi. Katılımcılar rastgele 2 gruba ayrıldı: Üriner kateter klempleme uygulanan 50 hastadan oluşan deney grubu (ameliyat sonrası 3. saatten sonra 3 kez, idrar sondasını 3 saat boyunca kapatarak ve sonra 5 dk boyunca açacak şekilde) ve idrar sondası klemplenmemiş 50 hastadan oluşan kontrol grubu. Çalışma verileri, maternal bilgi formu ve Üriner Sıkıntı Envanteri [Urinary Distress Inventory (UDI6)] ile toplanmıştır. UDI-6, subjektif işeme zorluğunu değerlendirmek için kullanıldı. Bu çalışmanın birincil sonucu, sezaryen uygulanan hastalarda detrusor kas egzersizi ile rezidüel idrar hacminde azalma olup olmadığını belirlemekti. İkincil sonuçlar, idrar yolu enfeksiyonu insidansı ve hastaların yaşadığı öznel semptomlardı. Bulgular: Deney (D) ve kontrol (K) gruplarında boşluk sonrası rezidüel idrar hacminin karşılaştırılmasına göre, ilk gün gruplar arasında anlamlı bir fark gözlenmedi [D=10 (%20), K=12 (%24), (p=0,629)]. İlk haftada [D=2 (%4), K=3 (%6), (p=1,000)] ve 6. haftada, her iki grupta da hiçbir hastada rezidüel idrar hacmi gözlenmedi. Gruplar arasında, zamana bağlı grup içi UDI-6 skorlarında yüzde değişim değerleri açısından istatistiksel fark yoktu (p=0,453). Deney grubundaki ortalama değişim %50,60 iken, kontrol grubunda bu değer %58,93 olarak elde edildi. Deney grubunda pozitif idrar kültürü olan katılımcıların oranı %6 iken, kontrol grubunda %4 olup, gruplar arasında anlamlı fark yoktu (p=1,000). Sonuç: Çalışmamızda, idrar sondası klempinin rezidüel idrar hacmi, idrar yolu enfeksiyonu ve subjektif idrar yapma zorluğu üzerinde azaltıcı etkisi yoktur.

Anahtar Kelimeler: Mesane egzersizi; idrar sondası klempleme; idrar retansiyonu; sezaryen
REFERENCES:
  1. O'Boyle AL, Mulla BM, Lamb SV, Greer JA, Shippe SH, Rollene NL. Urinary symptoms after bladder flap at the time of primary cesarean delivery: a randomized controlled trial (RTC). Int Urogynecol J. 2018;29(2):223-8. [Crossref]  [PubMed] 
  2. Liang CC, Chang SD, Chang YL, Chen SH, Chueh HY, Cheng PJ. Postpartum urinary retention after cesarean delivery. Int J Gynaecol Obstet. 2007;99(3):229-32. [Crossref]  [PubMed] 
  3. Chai AHL, Wong T, Mak HLJ, Cheon C, Yip SK, Wong ASM. Prevalence and associated risk factors of retention of urine after caesarean section. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(4):537-42. [Crossref]  [PubMed] 
  4. Mulder FEM. Postpartum urinary retention: risk factors, clinical impact and management. Int Urogynecol J. 2014;25(12):1605-12. [Crossref]  [PubMed] 
  5. Yip SK, Sahota D, Pang MW, Chang A. Postpartum urinary retention. Acta Obstet Gynecol Scand. 2004;83(10):881-91. [Crossref]  [PubMed] 
  6. Ross J. Some observations on the indwelling catheter. Practitioner. 1936;136(1):638-44.
  7. Roe B. Do we need to clamp catheters? Nurs Times. 1990;86(43):66-7.
  8. Getliffe K. Care of urinary catheters. Elder Care. 1996;8(2):23-6. [Crossref] 
  9. Crowe H, Clift R, Duggan G, Bolton D, Costello A. Randomized study of the effect of midnight removal of urinary catheters. Urol Nurs. 1994;14(1):18-20.
  10. Griffiths R, Fernandez R. Strategies for the removal of short-term indwelling urethral catheters in adults. Cochrane Database Syst Rev. 2007;2007(2):CD004011. [Crossref]  [PMC] 
  11. Wang LH, Tsai MF, Han CYS, Huang YC, Liu HE. Is bladder training by clamping before removal necessary for short-term indwelling urinary catheter inpatient? A systematic review and meta-analysis. Asian Nurs Res (Korean Soc Nurs Sci). 2016;10(3):173-81. [Crossref]  [PubMed] 
  12. Vassalo BJ, Kleeman SD, Segal LJ, Walsh P, Karram MM. Tension-free vaginal tape: a quality-of-life assessment. Obstet Gynecol. 2002;100(3):518-24. [Crossref]  [PubMed] 
  13. Cam C, Sakalli M, Ay P, Cam M, Karateke A. Validation of the short forms of the incontinence impact questionnaire (IIQ-7) and the urogenital distress inventory (UDI-6) in a Turkish population. Neurourol Urodyn. 2007;26(1):129-33. [Crossref]  [PubMed] 
  14. Williamson ML. Reducing post-catheterization bladder dysfunction by reconditioning. Nurs Res. 1982;31(1):28-30. [Crossref]  [PubMed] 
  15. Etafy MH, Saleh FH, Ortiz-Vanderdys C, Hamada A, Refaat AM, Aal MA, et al. Rapid versus gradual bladder decompression in acute urinary retention. Urol Ann. 2017;9(4):339-42. [Crossref]  [PubMed]  [PMC] 
  16. Christensen J, Ostri P, Frimodt-Møller C, Juul C. Intravesical pressure changes during bladder drainage in patients with acute urinary retention. Urol Int. 1987;42(3):181-4. [Crossref]  [PubMed] 
  17. Osius TG, Hinman F. Dynamics of acute urinary retention: a manometric, radiographic and clinical study. The Journal of Urology. 1963;90(6):702-12. [Crossref] 
  18. Kermans G, Wyndaele JJ, Thiery M, De Sy W. Puerperal urinary retention. Acta Urologica Belgica. 1987;54(4):376-85.
  19. Tiberon A, Carbonnel M, Vidart A, Halima MB, Deffieux X, Ayoubi JM. Risk factors and management of persistent postpartum urinary retention. J Gynecol Obstet Hum Reprod. 2018;47(9):437-41. [Crossref]  [PubMed] 
  20. Fillingham S, Douglas J. Urological Nursing. 3rd ed. London (UK): Bailliere Tindall; 2004. p.348.
  21. Zhengyong Y, Changxiao H, Shibing Y, Caiwen W. Randomized controlled trial on the efficacy of bladder training before removing the indwelling urinary catheter in patients with acute urinary retention associated with benign prostatic hyperplasia. Scand J Urol. 2014;48(4):400-4. [Crossref]  [PubMed] 
  22. Fernandez MA, Karthikeyan S, Wyse M, Foguet P. The incidence of postoperative urinary retention in patients undergoing elective hip and knee arthroplasty. Ann R Coll Surg Engl. 2014;96 (6):462-5. [Crossref]  [PubMed]  [PMC] 
  23. Lorzadeh N, Kazemirad S, Lorzadeh M. Urinary retention following the gynecologic surgeries and effect of Foley catheter clamping on its prophylaxis. J Med Sci. 2007;7(8):1358-61. [Crossref] 
  24. Nyman MH, Johansson JE, Gustafsson M. A randomized controlled trial on the effect of clamping the indwelling urinary catheter in patients with hip fracture. J Clin Nurs. 2010;19(3-4):405-13. [Crossref]  [PubMed] 
  25. Colli J, Tojuola B, Patterson AL, Ledbetter C, Wake RW. National trends in hospitalization from indwelling urinary catheter complications, 2001-2010. Int Urol Nephrol. 2014;46(2):303-8. [Crossref]  [PubMed] 
  26. Fanfani F, Costantini B, Mascilini F, Vizzielli G, Gallotta V, Vigliotta M, et al. Early postoperative bladder training in patients submitted to radical hysterectomy: is it still necessary? A randomized trial. Arch Gynecol Obstet. 2015;291(4):883-8. [Crossref]  [PubMed] 
  27. Mingxian LI, Hongying WEN, Yanfei LI. [Effect of initiative bladder function training on uroschesis and urinary tract infections after caesarean section]. Modern Clinical Nursing. 2016;15(7):31-3.

.: Up To Date

Login



Contact


Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com