Shrestha B, Marhatha R, Kayastha S, Jaishi S
Nepal Med Coll J. 2013 Jun;15(2):102-5.
Utero-vaginal prolapse is one of the commonest cause for vaginal operations in our country. The expense of this operation can be reduced by reducing duration of catheterization and thereby reducing hospital stay. A prospective, comparative hospital based study was used to assess whether removal of an in-dwelling catheter after 24 hours of vaginal operations with anterior colporrhaphy affects the rate of recatheterization, asymptomatic urinary tract infections, and hospital stay in comparison to 72 hours catheterization. We assigned 100 women who underwent vaginal operations. In-dwelling catheter was removed after 24 hours in group A and after 72 hours in group B. The association between Post-operative urinary retention, pus cells count > 5 per High Power Field, bacterial culture positivity and the length of catheterization were assessed by Chi square test. Recatheterization occurred in three patients (6%) of group A and none in group B (P value 0.241). Mean hospital stay after operation was 3.42 days in group A and 4.48 days in group B. Asymptomatic urinary tract infections (pus cells > 5 per High Power Field) occured in nine (18%) in group A and fifteen (30%) in group B (P value 0.16). Bacterial culture positivity occured in seven (14%) in group A and twenty-two (44%) in group B (P value 0.001). Despite increased recatheterization rate, early removal of in-dwelling catheters after uncomplicated vaginal hysterectomy pelvic floor repair and anterior colporrhaphy decreased mean catheterization time, mean hospital stay and asymtomatic urinary tract infection.
子宫阴道脱垂是我国阴道手术最常见的原因之一。通过缩短导尿时间从而减少住院时间,可以降低该手术的费用。一项基于医院的前瞻性对照研究旨在评估与留置导尿72小时相比,阴道前壁修补术后24小时拔除留置导尿管是否会影响再次导尿率、无症状性尿路感染及住院时间。我们纳入了100例行阴道手术的女性。A组在术后24小时拔除留置导尿管,B组在术后72小时拔除。采用卡方检验评估术后尿潴留、每高倍视野脓细胞计数>5、细菌培养阳性与导尿时间之间的关联。A组有3例患者(6%)需要再次导尿,B组无患者需要再次导尿(P值为0.241)。A组术后平均住院时间为3.42天,B组为4.48天。A组有9例(18%)发生无症状性尿路感染(每高倍视野脓细胞>5),B组有15例(30%)(P值为0.16)。A组细菌培养阳性率为7例(14%),B组为22例(44%)(P值为0.001)。尽管再次导尿率有所增加,但在单纯性阴道子宫切除、盆底修复及阴道前壁修补术后早期拔除留置导尿管可缩短平均导尿时间、平均住院时间及无症状性尿路感染的发生率。