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Subject Area

General Surgery

Article Type

Original Study

Abstract

Objectives To determine the necessity and safety of urethral catheterization in repeated versus primary cesarean section as it is not addressed clearly in the previous literature. Background Urethral catheterization is done as a routine procedure in a cesarean section. It is associated with high incidence of urinary tract infections, discomfort, delayed ambulation, and longer hospital stay. Patients and methods This randomized, controlled trial was carried out from April 2016 to October 2018; the study was conducted at Menoufia University Hospital, Obstetrics and Gynecology Department, the patients were recruited from the inward section. The study included 200 patients who were subjected to a cesarean section. After the selection of all patients, informed consent was obtained from all the participants. Ethics committee approval was obtained prior to the start of the study. The patients were randomly allocated by using a computer-generated random number table to either catheterized or noncatheterized. Results There were highly significant differences between primary and repeated cesarean sections with and without catheter as regards urine culture and sensitivity, signs and symptoms of urinary tract infection, first ambulation, and first voiding discomfort (P < 0.001), while there was no significant difference between them as regards the time of surgery and Postpartum hemorrhage (PPH) and there was no significant difference between them as regards age, gestational age, urine retention, bladder injury, and blood loss (P = 0.005). Conclusion Routine placement of indwelling urinary catheters for cesarean delivery in hemodynamically stable patients is not necessary and can be harmful. Moreover, the women needing catheterization should be selectively chosen. Thus, it should be selective catheterization rather than catheterization for all.

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