Use Versus Non-use of Bladder Catheterization in Elective Cesarean Delivery

Not Applicable

Not yet recruiting

Brief Summary: The goal of this randomized controlled trial is to investigate the impact of routine bladder catheterization in uncomplicated cesarean sections on hospitalization time (readiness to discharge), time to ambulation, urinary retention, development of urinary tract infections, prevention of bladder injury, operating time, and patient satisfaction.

Detailed Description: This would be a randomized controlled trial conducted on the labour and delivery and post-partum unit at a large academic site (Foothills Medical Centre) in Calgary, Alberta. Study recruitment of patients awaiting delivery via CS would occur either in participating prenatal clinics in Calgary or in obstetrical triage by a trained nurse research assistant. Participants would be randomized into either a catheterized or non-catheterized group prior to their scheduled elective CS. Allocation concealment will be ensured by using either a central computer generator for randomization if funding permits, otherwise sealed, opaque, and sequenced envelopes will be used. Since there may be potential differences in patients with increasing parity, randomization will be stratified by parity and blocked to prevent imbalance in treatment groups.

Recruitment & Eligibility

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Arm && Interventions

Group	Intervention	Description
Bladder catheterization	Bladder catheterization	Patients placed in the catheterized group will have an indwelling catheter placed after anesthetic has been administered. It would be removed at 12 hours post Cesarean section.

Primary Outcome Measures

Name	Time	Method
Time at readiness for discharge post-surgery	Prior to discharge, average of 2 days postpartum	Time at readiness for discharge post-surgery will be collected via a form that will be distributed to the postpartum nursing team.
Time to ambulation	Prior to discharge, an average of 2 days postpartum	Time to ambulation will be collected via a form that will be distributed to the postpartum nursing team.

Secondary Outcome Measures

Name	Time	Method
Incidence of bladder injury in surgery	During surgery	Incidence of bladder injury in surgery will be collected via an electronic post-operative questionnaire filled out by the operating surgeon.
Operating time	During surgery	Operating time will be collected via an electronic post-operative questionnaire filled out by the operating surgeon.
Incidence of urinary retention	Prior to discharge, an average of 2 days postpartum	Urinary retention will be defined based on a patient's inability to spontaneously void requiring either in-and-out catheterization or placement of an indwelling catheter during the post operative course
Incidence of urinary tract infections (UTI) requiring antibiotics in the first 4 weeks postpartum	first 4 weeks postpartum	Incidence of urinary tract infections (UTI) requiring antibiotics in the first 4 weeks postpartum
Patient satisfaction as measured by the Maternal Satisfaction for Cesarean Section questionnaire (MSCS)	Prior to discharge, an average of 2 days postpartum	Patients will be asked to complete the Maternal Satisfaction for Cesarean Section questionnaire at discharge. The minimum and maximum values are 7 and 154 and higher scores mean a better outcome.

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