Abstract：
OBJECTIVE: To determine the association between timing of indwelling catheter removal and urinary retention after cesarean.
METHODS: Retrospective cohort study.
METHODS: Eight hospitals in suburban, rural, and urban Colorado and Montana.
METHODS: Women who gave birth by cesarean from January 1, 2021, to April 30, 2022 (N = 3,496).
METHODS: We categorized participants who gave birth between January 1, 2021, and June 29, 2021, (before implementation of the Enhanced Recovery After Surgery initiative) into Group A and participants who gave birth between July 1, 2021, and April 30, 2022, (after implementation of the Enhanced Recovery After Surgery initiative) into Group B. We used descriptive statistics to report the proportion of participants in both groups who experienced urinary retention after birth. We performed chi-square tests to determine the association between the time of catheter removal and incidence of urinary retention. We used the Wilcoxon rank sum test to determine the association between length of stay and urinary retention.
RESULTS: Urinary retention rates were 5.8% in Group A and 12.6% in Group B (p < .001). In both groups, participants who received epidural anesthesia experienced significantly more urinary retention than those who received spinal anesthesia (p < .001). Participants who received epidural anesthesia and experienced urinary retention pushed 16.9% longer than those without urinary retention (p < .001). The proportion of participants who experienced urinary retention after catheter removal was 19.4% at 7 hours, 4.6% at 16 hours, and 9.9% at 12 hours after birth. Length of stay was determined to be inconclusive.
CONCLUSIONS: We determined that the optimal time of catheter removal to minimize the rate of urinary retention was 12 to 16 hours after cesarean among women who received morphine sulfate as the spinal anesthesia.
METHODS: Retrospective cohort study.
METHODS: Eight hospitals in suburban, rural, and urban Colorado and Montana.
METHODS: Women who gave birth by cesarean from January 1, 2021, to April 30, 2022 (N = 3,496).
METHODS: We categorized participants who gave birth between January 1, 2021, and June 29, 2021, (before implementation of the Enhanced Recovery After Surgery initiative) into Group A and participants who gave birth between July 1, 2021, and April 30, 2022, (after implementation of the Enhanced Recovery After Surgery initiative) into Group B. We used descriptive statistics to report the proportion of participants in both groups who experienced urinary retention after birth. We performed chi-square tests to determine the association between the time of catheter removal and incidence of urinary retention. We used the Wilcoxon rank sum test to determine the association between length of stay and urinary retention.
RESULTS: Urinary retention rates were 5.8% in Group A and 12.6% in Group B (p < .001). In both groups, participants who received epidural anesthesia experienced significantly more urinary retention than those who received spinal anesthesia (p < .001). Participants who received epidural anesthesia and experienced urinary retention pushed 16.9% longer than those without urinary retention (p < .001). The proportion of participants who experienced urinary retention after catheter removal was 19.4% at 7 hours, 4.6% at 16 hours, and 9.9% at 12 hours after birth. Length of stay was determined to be inconclusive.
CONCLUSIONS: We determined that the optimal time of catheter removal to minimize the rate of urinary retention was 12 to 16 hours after cesarean among women who received morphine sulfate as the spinal anesthesia.
摘要：
目的：确定拔除留置尿管的时机与剖宫产术后尿潴留的关系。
方法：回顾性队列研究。
方法：郊区的八家医院，农村,和城市科罗拉多州和蒙大拿州。
方法：2021年1月1日至2022年4月30日剖宫产分娩的妇女（N=3,496）。
方法：我们将在2021年1月1日至2021年6月29日之间分娩的参与者（在实施手术后增强恢复计划之前）分为A组，将在2021年7月1日至2022年4月30日之间分娩的参与者（在实施手术后增强恢复计划之后）分为B组。我们使用描述性统计来报告两组中出生后尿潴留的参与者比例。我们进行了卡方测试，以确定导管拔除时间与尿潴留发生率之间的关系。我们使用Wilcoxon秩和检验来确定住院时间和尿潴留之间的关联。
结果：A组尿潴留率为5.8%，B组为12.6%（p<.001）。在这两组中,接受硬膜外麻醉的参与者尿潴留明显多于接受脊髓麻醉的参与者(p<.001).接受硬膜外麻醉并有尿潴留的参与者比没有尿潴留的参与者延长16.9%（p<.001）。在拔除导尿管后7小时出现尿潴留的参与者比例为19.4%，16小时时4.6%，出生后12小时为9.9%。停留时间被确定为不确定。
结论：我们确定，在接受硫酸吗啡作为脊髓麻醉的妇女中，剖宫产后12至16小时拔除导管以减少尿潴留的最佳时间。
方法：回顾性队列研究。
方法：郊区的八家医院，农村,和城市科罗拉多州和蒙大拿州。
方法：2021年1月1日至2022年4月30日剖宫产分娩的妇女（N=3,496）。
方法：我们将在2021年1月1日至2021年6月29日之间分娩的参与者（在实施手术后增强恢复计划之前）分为A组，将在2021年7月1日至2022年4月30日之间分娩的参与者（在实施手术后增强恢复计划之后）分为B组。我们使用描述性统计来报告两组中出生后尿潴留的参与者比例。我们进行了卡方测试，以确定导管拔除时间与尿潴留发生率之间的关系。我们使用Wilcoxon秩和检验来确定住院时间和尿潴留之间的关联。
结果：A组尿潴留率为5.8%，B组为12.6%（p<.001）。在这两组中,接受硬膜外麻醉的参与者尿潴留明显多于接受脊髓麻醉的参与者(p<.001).接受硬膜外麻醉并有尿潴留的参与者比没有尿潴留的参与者延长16.9%（p<.001）。在拔除导尿管后7小时出现尿潴留的参与者比例为19.4%，16小时时4.6%，出生后12小时为9.9%。停留时间被确定为不确定。
结论：我们确定，在接受硫酸吗啡作为脊髓麻醉的妇女中，剖宫产后12至16小时拔除导管以减少尿潴留的最佳时间。
