Urinary catheterization management after vaginal prolapse surgery:A national survey among Chinese urogynecologists and nurses

Background:Urinary catheterization after vaginal prolapse surgery can cause inconvenience for patients,elevate the risk of urinary tract infections,and potentially prolong the hospitalization.In China,there is no consensus on the optimal time to remove the urinary catheter after vaginal prolapse surgery.Thus,it will be valuable to gain insight into the nationwide catheterization management after the vaginal prolapse surgery.Methods:From March to May 2020,an online questionnaire was shared and purposive non-probabilistic sampling was used to recruit the participants.The urogynecologists currently performing vaginal prolapse surgery and involved nurses were included in this study.Results:1363 urogynecologists and 436 nurses responded and 99.5%of them reported using transurethral indwelling catheters(TIC)for post-operative bladder drainage in their practices.The duration of initial catheterization after vaginal prolapse surgery was generally 1–7 days,with a median duration of 3 days for anterior colporrhaphy(AC)and anterior&posterior colporrhaphy(APC),and 2 days for other procedures.For the same type of surgery,the median duration of catheterization varied by region.For AC,it was shorter by 1 day in West China and South China(P<0.001);for PC,it was 2 days in most regions,while 1 day in East China(P<0.05);and for APC,it was 3 days in most regions,while 4 days in Northeast China(P<0.05).No statistically significant difference was found in duration of catheterization in hospital levels.Conclusions:The findings suggested that duration of catheterization after prolapse surgery varied greatly in China,potentially resulting in unnecessary prolonging of catheterization.Well-designed studies are urgently needed to optimize catheterization management after vaginal prolapse surgery in China.

Acute Postpartum Urine Retention: Case Report and Review of the Literature

Introduction: Acute postpartum urine retention is a condition whose failure to recognize it can lead to delays in diagnosis, which can worsen the prognosis, and to inappropriate management. It occurs in 0.7% to 0.9% of vaginal deliveries. Its aetiology is multifactorial. There are many risk factors. Treatment is based on intermittent evacuation catheterization. Today, there is no consensus on the management of this condition, which has received little attention in African literature. Hence the interest of this article. Clinical Case: This is a 46 years old female, G5P5 005, with no prior history of involvement, who, after a dystocic vaginal delivery (longer than 12 hours with long foetal expulsion) and at term of a female newborn weighing 3475 g, developed hypogastric pain and spontaneous failure to urinate within 24 hours of delivery. The physical examination revealed abdominal tenderness and dullness with a strong desire to urinate and a normal neurological examination. The diagnosis was postpartum urinary retention. A bladder catheter inserted through the urethra drained 1100 ml of clear urine. Management consisted of physical measures and the prescription of an alpha blocker (Alfuzosin 4 mg). Two days later, the patient urinated normally. Conclusion: Acute postpartum retention in routine practice is rare but may be underestimated. Measures need to be taken to diagnose and manage this complication and also to determine the epidemiology of this postpartum complication.