A randomized controlled trial of 12 hours versus 24 hours urinary catheter removal following uncomplicated caesarean section in Ekiti State, Nigeria

Benedict T. Adeyanju, Olusola P. Aduloju, Jacob O . Awoleke, Adeyemi S. Adefisan, Babatunde Olofinbiyi

Abstract

Catheter-associated urinary tract infection (CA-UTI) is one of the common nosocomial infection. Minimizing the length of stay of indwelling urinary catheter has been reported as a key strategy in reducing the rate of the infection. This study compared the incidence of significant bacteriuria in patients who had removal of their urinary catheter in 12 hours compared to those removed after 24 hours following uncomplicated caesarean section. A total of 140 women were randomized into two groups of either 12- hour catheter removal (group A) or 24-hour catheter removal (group B) post-caesarean section. The socio-demographic characteristics, pre-operative and post-operative urine microscopy, culture and sensitivity, time of first ambulation, length of hospital stay and the cost of treatment for all the participants were analyzed using SPSS version 21. P value was set at 0.05. results showed the overall incidence of catheter associated significant bacteriuria was 26.3% in this study while participants in group A (20.9%) had lower incidence of microscopic bacteriuria compared to those in group B (31.8%) though not statistically significant [OR= 1.8: 95%CI (0.8-3.9); p=0.1]. The mean time of first ambulation was statistically lower in group A compared to group B (16.2 ± 7.7 hours versus 24.8 ± 4.3 hours, p<0.001 respectively). The socio-demographic characteristics, incidence of urinary retention, mean length of hospital stay and cost of treatment did not differ significantly between the groups, p >0.05. The study demonstrated that catheter removal at 12 hours post uncomplicated caesarean section can enhance early ambulation and reduce the incidence of post-operative microscopic bacteria. ClinicalTrials.gov identifier PACTR201912777385309

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