Duration of Urinary Catheterization Following Cesarean Deliveries Under Neuraxial Anesthesia

Duration of Urinary Catheterization Following Cesarean Deliveries Under Neuraxial Anesthesia: A Prospective Cohort Study

In cesarean deliveries, urinary catheters are often used to help empty the bladder while patients have limited mobility. These catheters typically stay in during early recovery because certain pain medications can make it hard for patients to urinate. Recently, the Society of Obstetric Anesthesia and Perinatology (SOAP) recommended removing catheters within 6-12 hours after delivery to aid recovery. However, at BC Women's Hospital, a review found that catheters stayed in for an average of 19 to 19.4 hours, even when patients were mobile.

Leaving catheters in too long can increase the risk of urinary tract infections (UTIs), pain, and urination issues, which can delay recovery and extend hospital stays. An internal review showed that factors like patient anxiety may affect when catheters are removed. Postpartum anxiety affects around 9.9% to 20.7% of new mothers in the first year and is an important factor in recovery after a cesarean delivery.

The main goal of this study is to look at how long urinary catheters stay in patients who had a cesarean delivery under spinal or epidural anesthesia, and what the score is from a questionnaire used to measure anxiety called the State Trait Anxiety Inventory (STAI-S), to see if there is a link between them.

This study aims to analyze how long foley catheters stay in the patient after their cesarean delivery under neuraxial anesthesia and what barriers there are in taking them out earlier.

Inclusion Criteria:

• Patients ≥19 years of age.
• Undergoing cesarean delivery (elective or emergent) at BC Women's Hospital.
• Neuraxial anesthesia as their primary mode of anesthesia (spinal, epidural, combined spinal-epidural, dural-puncture epidural).
• In-patient status at 24 (+/- 8) hours.
• Self-reported proficiency in speaking and reading English.

Exclusion Criteria:

• Refusal to participate.
• Inability to provide informed consent.
• Other surgery (i.e. cervical cerclage) or delivery modes (i.e. operative vaginal delivery).
• De novo general anesthetic, or patients who had a conversion from neuraxial to a general anesthetic.
• Communication from patient's nurse indicating that it is not appropriate to approach due to distressing birth experience and/or outcome.