Du Jason, Marshall Daniel, Leyland John, Shaw Leanne, Broome Kim E, Mason David F C
Department of Urology, Hawkes Bay Hospital, Omahu Road, Hastings 4120, New Zealand.
ANZ J Surg. 2013 Apr;83(4):239-42. doi: 10.1111/j.1445-2197.2012.06253.x. Epub 2012 Sep 18.
The objective of this study was to investigate whether bladder filling with saline prior to trial of void (TOV) was safe and whether it reduced time to discharge compared with standard TOV in the urology inpatient setting for patients post-transurethral resection of prostate, bladder neck incision or an admission with urinary retention.
Prospective, multicentre, randomized controlled trial at Hawkes Bay and Waikato hospitals with local ethics committee approval. All consecutive, consented patients requiring TOV were randomized into filling and control groups. The filling groups were filled with normal saline prior to TOV (up to 500 mL or first sensation of fullness). The control group had their catheter removed at 06.00 hours without filling. Time taken between catheter removal and discharge was recorded in minutes. Complications were recorded.
Fifty-two patients were recruited and randomized with 27 and 25 patients in the filling and control groups, respectively. The mean time taken from catheter removal to discharge was 300.6 min in the filling group and 340.1 min in the control group. The filling group reduced the time to discharge by 39.5 min (P = 0.304). Furthermore, 2/27 and 2/25 patients in the filling and control groups, respectively, developed urinary retention after TOV and required re-catheterization prior to discharge.
Bladder filling prior to TOV showed a non-statistically significant reduction in the time to discharge of 39.5 min. Despite the fact that bladder filling is a safe and cheap procedure, it cannot be recommended for use in an attempt to reduce time to discharge in an inpatient setting.
本研究的目的是调查在泌尿外科住院患者中,经尿道前列腺切除术、膀胱颈切开术或因尿潴留入院的患者,在试行排尿(TOV)前膀胱灌注生理盐水是否安全,以及与标准TOV相比是否能缩短出院时间。
在霍克斯湾和怀卡托医院进行前瞻性、多中心、随机对照试验,并获得当地伦理委员会批准。所有需要TOV且连续入选并同意的患者被随机分为灌注组和对照组。灌注组在TOV前用生理盐水灌注(最多500毫升或有胀满感)。对照组在06:00拔除导尿管,不进行灌注。记录从拔除导尿管到出院的时间(以分钟计)。记录并发症情况。
共招募52例患者并随机分组,灌注组27例,对照组25例。灌注组从拔除导尿管到出院的平均时间为300.6分钟,对照组为340.1分钟。灌注组使出院时间缩短了39.5分钟(P = 0.304)。此外,灌注组和对照组分别有2/27和2/25的患者在TOV后发生尿潴留,出院前需要重新留置导尿管。
TOV前膀胱灌注使出院时间缩短39.5分钟,但差异无统计学意义。尽管膀胱灌注是一种安全且廉价的操作,但不建议在住院环境中用于缩短出院时间。