Comparison between use and nonuse of urethral catheterization during cesarean section on the prevalence of urinary tract infection: A prospective randomized controlled trial

Abstract

Cesarean section is one of the most commonly performed surgical procedures in obstetrics. Maternal mortality associated with the procedure is becoming rare as a result of improved anesthetic techniques, thromboprophylaxis and a wider choice of potent antibiotics. Catheterization of urinary bladder prior to cesarean section is a long-standing practice that has been continued for a long time without being subjected to critical evaluation The main disadvantage of catheterization is the increased risk of urinary tract infection (UTI) This prospective randomized controlled trial was designed to compare between use and nonuse of urethral catheterization during cesarean section on the prevalence of urinary tract infection, also to detect any postpartum complications caused by catheterization and the dominant type of micro organisms causing urinary tract infection. This study was carried out on 428 patients with verbal consent, undergoing elective cesarean sections that were randomly assigned by a computer generated list and were divided into two equal groups:

Group A: including 214 gravid women undergoing elective lower segment cesarean section .These women are catheterized immediately before cesarean section with indwelling Foley’s catheter and catheter is removed 12 hours post cesarean section.

Group B: including 214 gravid women undergoing elective lower segment cesarean section without catheterization All women were evaluated by preoperative urine analysis and history taking to exclude any history of urinary tract infection during pregnancy, and encouraged to void urine 1 hour before operation. All patients included in this trial were subjected to elective cesarean section by the ordinary classic technique after general anesthesia Both groups postoperatively were subjected to: • Routine analgesia, fluids and nursing. • Evaluation of possible complications by: symptoms, signs and investigations (urine culture and sensitivity 24 hours post operative).

All women were asked about post operative symptoms suggesting of urinary tract infection including: Dysuria defined as painfully micturition. Urgency defined as sudden compelling