Ahmed Magdy R, Sayed Ahmed Waleed A, Atwa Khaled A, Metwally Lobna
Department of Obstetrics and Gynecology, Suez Canal University, Egypt.
Department of Obstetrics and Gynecology, Suez Canal University, Egypt.
Eur J Obstet Gynecol Reprod Biol. 2014 May;176:60-3. doi: 10.1016/j.ejogrb.2014.02.038. Epub 2014 Mar 4.
To assess whether immediate (0h), intermediate (after 6h) or delayed (after 24h) removal of an indwelling urinary catheter after uncomplicated abdominal hysterectomy can affect the rate of re-catheterization due to urinary retention, rate of urinary tract infection, ambulation time and length of hospital stay.
Prospective randomized controlled trial conducted at Suez Canal University Hospital, Egypt. Two hundred and twenty-one women underwent total abdominal hysterectomy for benign gynecological diseases and were randomly allocated into three groups. Women in group A (73 patients) had their urinary catheter removed immediately after surgery. Group B (81 patients) had the catheter removed 6h post-operatively while in group C (67 patients) the catheter was removed after 24h. The main outcome measures were the frequency of urinary retention, urinary tract infections, ambulation time and length of hospital stay.
There was a significantly higher number of urinary retention episodes requiring re-catheterization in the immediate removal group compared to the intermediate and delayed removal groups (16.4% versus 2.5% and 0% respectively). Delayed urinary catheter removal was associated with a higher incidence of urinary tract infections (15%), delayed ambulation time (10.3h) and longer hospital stay (5.6 days) compared to the early (1.4%, 4.1h and 3.2 days respectively) and intermediate (3.7%, 6.8h and 3.4 days respectively) removal groups.
Removal of the urinary catheter 6h postoperatively appears to be more advantageous than early or late removal in cases of uncomplicated total abdominal hysterectomy.
评估单纯性腹式子宫切除术后立即（0小时）、中期（6小时后）或延迟（24小时后）拔除留置导尿管是否会影响因尿潴留导致的再次导尿率、尿路感染率、下床活动时间及住院时间。
在埃及苏伊士运河大学医院进行的前瞻性随机对照试验。221名因良性妇科疾病接受全腹式子宫切除术的女性被随机分为三组。A组（73例患者）术后立即拔除导尿管。B组（81例患者）术后6小时拔除导尿管，而C组（67例患者）术后24小时拔除导尿管。主要观察指标为尿潴留频率、尿路感染、下床活动时间及住院时间。
与中期和延迟拔除组相比，立即拔除组因尿潴留需要再次导尿的次数明显更多（分别为16.4%、2.5%和0%）。与早期拔除组（分别为1.4%、4.1小时和3.2天）和中期拔除组（分别为3.7%、6.8小时和3.4天）相比，延迟拔除导尿管与更高的尿路感染发生率（15%）、延迟下床活动时间（10.3小时）及更长的住院时间（5.6天）相关。
在单纯性全腹式子宫切除术中，术后6小时拔除导尿管似乎比早期或晚期拔除更具优势。
