Department of Medicine, Evidence Based Health Care Post-Graduate Program, São Paulo Federal University, São Paulo, Brazil.
Women's Health Research Unit, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Int J Gynaecol Obstet. 2018 Jul;142(1):15-22. doi: 10.1002/ijgo.12462. Epub 2018 Mar 12.
Bladder catheterization duration after urinary obstetric fistula surgery varies widely.
To assess the effect of bladder catheterization duration after urinary obstetric fistula surgery.
Medline, EMBASE, CINAHL, GIM, and POPLINE databases were searched, without language restrictions, using "obstetric urinary fistula" and "catheterization" from inception to September 30, 2017.
Randomized controlled trials comparing shorter versus longer (>10 days) bladder catheterization after urinary obstetric fistula repair were included.
Data were extracted and meta-analyses were conducted. The GRADE system was used to assess evidence quality.
Two unblinded non-inferiority trials (684 patients combined) were included. There were no differences between shorter and longer bladder catheterization in the risk of fistula repair breakdown either before (relative risk [RR] 1.14; 95% confidence interval [CI] 0.49-2.64) or after (RR 1.64; 95% CI 0.81-3.31) hospital discharge. Similarly, urinary infection (RR 5.18; 95% CI 0.25-107.44); urinary incontinence before (RR 1.15; 95% CI 0.54-2.43) or after (RR 1.16; 95% CI 0.62-2.18) discharge; urinary retention (RR 1.34; 95% CI 0.79-2.27); or extended hospital stay (RR 9.33; 95% CI 0.51-172.41) were not associated with duration of catheterization. Evidence quality was low or moderate.
Shorter, compared to longer, bladder catheterization duration after urinary obstetric fistula surgery was not associated with significant outcome differences.
尿瘘手术后导尿管留置时间差异很大。
评估尿瘘手术后导尿管留置时间的影响。
检索 Medline、EMBASE、CINAHL、GIM 和 POPLINE 数据库，检索词为“产科尿瘘”和“置管”，时间为建库至 2017 年 9 月 30 日，无语言限制。
比较尿瘘修复术后短时间（<10 天）与长时间（>10 天）留置导尿管的随机对照试验。
提取数据并进行荟萃分析。采用 GRADE 系统评估证据质量。
纳入 2 项非盲非劣效性试验（共 684 例患者）。在出院前（相对风险 [RR] 1.14；95%置信区间 [CI] 0.49-2.64）或出院后（RR 1.64；95% CI 0.81-3.31），较短和较长的导尿管留置时间在瘘修补术破裂风险方面没有差异。同样，尿路感染（RR 5.18；95% CI 0.25-107.44）；出院前（RR 1.15；95% CI 0.54-2.43）或出院后（RR 1.16；95% CI 0.62-2.18）尿失禁；尿潴留（RR 1.34；95% CI 0.79-2.27）；或延长住院时间（RR 9.33；95% CI 0.51-172.41）与导尿管留置时间无关。证据质量为低或中。
与较长时间相比，尿瘘手术后较短时间的导尿管留置时间与显著的结局差异无关。
