A prospective randomized clinical trial of urethral catheter removal following elective cesarean delivery

Objective: To compare immediate and 24-hour postoperative removal of urethra[ catheters for elective cesarean delivery. Method: A prospective randomized trial of 200 women admitted for elective cesarean delivery where the urethra[ catheter was removed 24 hours postoperatively or immediately after the procedure. Urine samples were collected preoperatively and 72 hours postoperatively for microscopy, culture, and sensitivity (MCS). Outcome measures included preoperative and 72-hour postoperative urine MCS, postoperative morbidities, and length of hospital stay. Results: There were no significant differences in postoperative urinary retention (P=0.986), dysuria (P=0.188), urgency (P=0.134), fever (P=1.000), 72-hour postoperative urine MCS (P=0.489), and length of hospital stay (P=0.879) between the 2 groups. There was a nonsignificant lower incidence of positive urine culture 72 hours postoperatively for women in the immediate removal group compared with those who were catheterized for 24 hours (8.1% vs 11.2%; P=0.489). Conclusion: Immediate postoperative removal of a urethral catheter after elective cesarean delivery may be associated with a lower risk of urinary infection. (c) 2008 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.