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Effect of Intermittent Catheter Clamping Training on Postoperative Urinary Function Recovery in Patients Undergoing
1Department of Gynecology, Dongguan Maternal and Child Health Hospital, Guangdong, 523000, China. 13728223219@163.com.
Introduction And Hypothesis:
To investigate the effect of intermittent urinary catheter clamping training on the recovery of urinary function in patients after pelvic-floor reconstruction surgery.
Methods:
A prospective randomized study enrolled patients who underwent pelvic-floor reconstruction at a tertiary hospital from November 2024 to March 2025, with randomization to continuous drainage (n = 90) or intermittent clamping (n = 90) groups (sample size based on pilot data). Outcome measures included 24-/48-h voiding success, 1st-, 3rd-, and 6th-week incidence of urinary retention and urinary tract infection (UTI), as well as postoperative maximum urinary flow rate (Qmax) and Quality of Recovery-15 (QoR-15) score.
Results:
Baseline characteristics were balanced (all p > 0.05). Intermittent clamping significantly improved 48-h voiding success (69.2% in the control group vs 86.4% in the intervention group, p = 0.047) and postoperative Qmax at all follow-up time points (all p < 0.001); UTI/urinary retention rates and hospital stay of the two groups were comparable. QoR-15 score was significantly higher in the clamping group at the 1st (absolute mean difference = 1.12 points), 3rd (absolute mean difference = 1.49 points), and 6th (absolute mean difference = 0.91 points) weeks (all p < 0.05), but did not meet the eight-point MCID. Subgroup analysis by surgical type showed that intermittent clamping improved Qmax in both the pelvic-floor repair with continence surgery and the repair alone subgroups (all p < 0.01). Subgroup analysis (preoperative PVR > 30 ml) showed that the clamping group had significantly reduced urinary retention (p = 0.031) and higher Qmax (p < 0.05).
Conclusions:
Intermittent catheter clamping after pelvic-floor reconstructive surgery enhances postoperative bladder function (higher Qmax) without increasing UTI risk or compromising recovery experience. It notably reduces urinary retention in patients with preoperative postvoid residual > 30 ml, serving as a valuable targeted perioperative strategy.
