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. 2024 Nov 7:8.
doi: 10.18332/ejm/193602. eCollection 2024.

Association between duration of urinary catheterization and post-operative mobilization following elective cesarean section: A retrospective case-control study in Espoo, Finland

Hanna Vihervaara  1 , Antti Väänänen  2 , Marja Kaijomaa  2
Affiliations

Association between duration of urinary catheterization and post-operative mobilization following elective cesarean section: A retrospective case-control study in Espoo, Finland

Hanna Vihervaara et al. Eur J Midwifery. .

Abstract

Introduction: Cesarean section is the most common surgery performed on women. The enhanced recovery recommendations are early urinary catheter removal and early mobilization, as essential elements of post-operative care. This study aimed to analyze the association between these elements and whether limiting the catheter treatment duration affects the timing of post-operative mobilization.

Methods: This retrospective case-control study compared the mobilization of healthy elective cesarean patients under different instructions on urinary catheter removal: cases with a preset catheter removal time (8-12 hours) and controls with catheter removal based on midwife considerations. Apart from the preset time of catheter removal, the routine post-operative care was given by the same personnel without any advice on patient mobilization. Data on patient demographics, surgery details, post-operative medication, first upright mobilization, the length of hospital stay, and patient satisfaction were analyzed.

Results: The study comprised 52 cases and one control for each case (N=104). The mean duration of urinary catheterization was 20.15 ± 6.59 and 11.30 ± 4.20 hours in the control and intervention groups, respectively (p<0.001). A linear regression analysis showed a significant association between the catheter removal time and patient mobilization, when adjusted for maternal background parameters (age, BMI, fear of childbirth diagnosis, prior uterine scar), duration and timing of the surgery, bleeding and post-operative analgesic use (R2=0.444, p<0.001). No difference was detected in the length of hospital stay, or patient satisfaction.

Conclusions: Limiting the duration of urinary catheter therapy is associated with shorter time to post-operative mobilization. A prospective randomized trial would provide more detailed information.

Keywords: cesarean section; enhanced recovery; maternal satisfaction; mobilization; post-operative pain; urinary catheter.

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Conflict of interest statement

The authors have each completed and submitted an ICMJE form for Disclosure of Potential Conflicts of Interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. A. Väänänen reports receiving support for the present work from the University of Helsinki Central Hospital, Women’s Hospital, Department of Obstetrics and Anesthesiology (permitted the study and facilitated access to the patient records). She also reports receiving funding for the article processing charges that will be covered from the University of Helsinki Library. Furthermore, she reports receiving facilitated leave of absence from clinical work to complete this study from the Finnish Medical Foundation (personal grant).

Figures

Figure 1
Figure 1
Scatter plot of time to mobilization by duration of urinary catheterization in Espoo Hospital, Finland (N=104) (both parameters counted as hours after end of surgery)
See this image and copyright information in PMC

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