Glavind Karin, Mørup Lisbeth, Madsen Hans, Glavind Julie
Department of Gynecology and Obstetrics, Aalborg Sygehus, Aalborg, Denmark.
Acta Obstet Gynecol Scand. 2007;86(9):1122-5. doi: 10.1080/00016340701505317.
The aim of this prospective, randomised, study was to determine whether or not there was a higher incidence of bleeding, reoperation, urinary retention or bacterial count in the urine, depending on whether urinary catheter and vaginal pack was removed 3 h or 24 h after vaginal prolapse surgery.
Some 136 women were randomised into Group 1 (removal of catheter and vaginal pack after 3 h), and Group 2 (removal of catheter and vaginal pack after 24 h). Data on postoperative bleeding, reoperation, and urinary retention were collected. Preoperatively, day after operation, and 14 days after operation, a urine culture was performed.
There was no tendency towards more bleeding with early removal of vaginal pack and urinary catheter. No patients in either group were reoperated during the first 48 postoperative hours. Three patients in Group 1 required sterile intermittent catheterisation postoperatively, however, only once in 2 patients. There was a trend towards a higher postoperative bacterial count in patients in Group 2 (p=0.306).
We recommend removing the vaginal pack and urinary catheter after 3 h with careful monitoring of the patient's voiding.
这项前瞻性随机研究的目的是,根据阴道脱垂手术后3小时或24小时拔除导尿管和阴道填塞物的情况,确定出血、再次手术、尿潴留或尿液细菌计数的发生率是否更高。
约136名女性被随机分为第1组(3小时后拔除导尿管和阴道填塞物)和第2组(24小时后拔除导尿管和阴道填塞物)。收集术后出血、再次手术和尿潴留的数据。术前、术后第1天和术后14天进行尿培养。
早期拔除阴道填塞物和导尿管并没有增加出血的倾向。两组患者在术后48小时内均未进行再次手术。第1组有3例患者术后需要无菌间歇性导尿,不过,2例患者仅导尿1次。第2组患者术后细菌计数有升高趋势(p = 0.306)。
我们建议在3小时后拔除阴道填塞物和导尿管,并密切监测患者排尿情况。