Alessandri Franco, Mistrangelo Emanuela, Lijoi Davide, Ferrero Simone, Ragni Nicola
Department of Obstetrics and Gynecology, Genova University, Italy.
Acta Obstet Gynecol Scand. 2006;85(6):716-20. doi: 10.1080/00016340600606976.
A prospective, randomized study was used to assess whether the immediate removal of an in-dwelling catheter after hysterectomy affects the rate of recatheterization, symptomatic urinary tract infections, time of ambulation, and hospital stay.
We randomly assigned 96 women who underwent hysterectomy [44 vaginal hysterectomy (VH), 37 abdominal hysterectomy, and 15 laparoscopic assisted VH) to three groups. The in-dwelling catheter was removed immediately (group A), at 6 hr (group B), or at 12 hr (group C) after the operation. The association between clinical variables and the length of catheterization was assessed by Chi-square analysis.
Recatheterization occurred in six patients (18.8%) of group A, all after VH under spinal anesthesia. All patients in the groups B and C could spontaneously void the bladder after catheter removal. Symptomatic urinary tract infection occurred in one patient in group A, compared with four patients in group B, and five in group C. The mean time to ambulation was 4.3 hr in group A, 6.5 hr in group B, and 9.4 hr in group C. Patients with immediate removal of urinary catheter had a shorter hospital stay.
There could be an association between necessity of recatheterization and the type of surgery (VH) or the type of anesthesia (spinal). Despite recatheterization rate, early removal of in-dwelling catheters immediately after uncomplicated hysterectomy seems to decrease first ambulation time and hospital stay.
一项前瞻性随机研究旨在评估子宫切除术后立即拔除留置导尿管是否会影响再次导尿率、有症状的尿路感染、下床活动时间和住院时间。
我们将96例行子宫切除术的女性（44例行阴道子宫切除术、37例行腹式子宫切除术和15例行腹腔镜辅助阴道子宫切除术）随机分为三组。术后立即拔除留置导尿管（A组）、术后6小时拔除（B组）或术后12小时拔除（C组）。通过卡方分析评估临床变量与导尿时间长短之间的关联。
A组有6例患者（18.8%）需要再次导尿，均为在脊髓麻醉下接受阴道子宫切除术的患者。B组和C组的所有患者在拔除导尿管后均能自行排尿。A组有1例患者发生有症状性尿路感染，B组有4例，C组有5例。A组患者的平均下床活动时间为4.3小时，B组为6.5小时，C组为9.4小时。导尿管立即拔除的患者住院时间较短。
再次导尿的必要性可能与手术类型（阴道子宫切除术）或麻醉类型（脊髓麻醉）有关。尽管存在再次导尿率，但在简单子宫切除术后立即早期拔除留置导尿管似乎可缩短首次下床活动时间和住院时间。
