Immediate postoperative removal of a urethral catheter after elective cesarean delivery may be associated with a lower risk of urinary infection.

A prospective randomised study of 54 patients undergoing caesarean section was carried out to determine if non-closure of peritoneum at lower segment caesarean section has advantages over suture peritonisation with regard to postoperative morbidity. A total of 27 women were randomised to closure and 27 to non-closure of peritoneum. Management decisions were made without reference to treatment groups. Statistical analysis compared the outcome between the two groups. The results revealed that anaesthesia and operating times were significantly shorter in patients that had the peritoneum left open. The incidence of febrile morbidity, wound infection, duration of postoperative and duration of hospital stay were not significantly different in both groups ( p < 0.05). The study concludes that non-closure of peritoneum is associated with significantly reduced operation and anaesthesia time with a non-significant difference in immediate postoperative outcome. Non-closure of peritoneum should be adopted at caesarean delivery.

Background: There is no consensus on the preferred time to remove urethral catheter post caesarean section. Aim: To compare rate of significant bacteriuria and urinary retention following 8-h (study) and 24-h urethral catheter removal (control) post elective caesarean section. Methods: A randomized controlled trial of eligible participants that underwent elective caesarean section under spinal anaesthesia between March 2019 and November 2019 was conducted. Participants (150 in each arm) were randomly assigned (1:1 ratio) to either 8-h or 24-h group. Primary outcome measures included rates of significant bacteriuria 48-h post-operatively and acute urine retention 6-h post urethral catheter removal. Analysis was by Intention-to-treat. ( www.pactr.org:PACTR202105874744483 ) Results: There were 150 participants randomized into each arm and data collection was complete. Significant bacteriuria was less in 8-h group (3% versus 6.0%; risk ratio (RR): 0.85 CI: 0.60 to 5.66; p = 0.274), though not significant. Acute urinary retention requiring repeat catheterisation was significantly higher in 8-h group (11(7.3%) versus 0(0.0%); RR: 0.07; CI: 0.87 to 0.97; p = 0.001). Mean time until first voiding was slightly higher in 8-h group (211.4 ± 14.3 min versus 190.0 ± 18.3 min; mean difference (MD): 21.36; CI: −24.36 to 67.08; p = 0.203); but patient in this group had a lower mean time until ambulation (770.0 ± 26.1 min versus 809 ± 26.2 min; MD: −38.8; CI: −111.6 to 34.0; p = 0.300). The 8-h group were significantly more satisfied (82/150 (54.7%) versus 54/150 (36.0%); p = 0.001) Conclusions: An 8-h group was associated with significant clinical satisfaction and acute urine retention compared to 24-h removal. The timing of urethral catheter removal did not affect rate of significant bacteriuria and other outcomes