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Intermittent vs continuous catheterization for postpartum urinary retention: A multicenter randomized controlled

Gal Bachar1, Yoav Siegler1, Eli Kabakov1

  • 1Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel (Dr Bachar, Dr Siegler, Dr Kabakov, Dr Lauterbach, Dr Justman, Dr Khatib, Dr Zipori, Dr Weiner, and Dr Vitner).

American Journal of Obstetrics & Gynecology MFM
|July 9, 2023
PubMed
Summary

Intermittent catheterization resolves postpartum urinary retention faster than continuous catheterization. This method also improves patient satisfaction without increasing complication rates for postpartum urinary retention management.

Keywords:
catheterizationindwellingintermittentpostpartum urinary retentionpregnancy

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Area of Science:

  • Obstetrics and Gynecology
  • Urology
  • Clinical Trials

Background:

  • Postpartum urinary retention (PUR) is a common complication following childbirth.
  • Optimal management strategies for PUR lack established consensus.
  • Existing treatments may not fully address patient comfort and recovery speed.

Purpose of the Study:

  • To compare the efficacy and patient experience of two distinct catheterization strategies for managing postpartum urinary retention.
  • To determine if intermittent catheterization offers advantages over continuous catheterization in terms of resolution time and patient satisfaction.
  • To evaluate the impact of each strategy on complication rates such as urinary tract infections and hospital stay duration.

Main Methods:

  • A multicenter prospective randomized controlled trial involving 147 participants with PUR.
  • Participants were randomized to either intermittent catheterization (every 6 hours, up to 4 times) or continuous catheterization (indwelling catheter for 24 hours).
  • Primary endpoint: mean time to PUR resolution. Secondary endpoints: UTI rates, hospital stay length, and patient satisfaction (30-Item Birth Satisfaction Scale).

Main Results:

  • Intermittent catheterization demonstrated a significantly shorter mean time to PUR resolution (10.2 hours) compared to continuous catheterization (26.5 hours) (P<.001).
  • Higher resolution rates were observed with intermittent catheterization at 24 hours (99% vs 91%, P=.043).
  • Patient satisfaction scores were significantly higher across all categories in the intermittent catheterization group (P<.001), with no significant differences in UTI rates or hospital stay length.

Conclusions:

  • Intermittent catheterization is a more effective strategy for managing postpartum urinary retention, leading to faster resolution.
  • This approach significantly enhances patient satisfaction compared to continuous catheterization.
  • Intermittent catheterization provides these benefits without an increased risk of complications, making it a preferred management option.