Duration of postoperative catheterization: A randomized, doubleblind trial comparing two catheter management protocols and the effect of bethanechol chloride
Tóm tắt
A randomized trial of two postoperative suprapubic catheter clamping protocols was undertaken to compare their effect on the duration of both postoperative indwelling catheter time and hospital stay. In addition, patients were given either bethanechol chloride or placebo in a double-blind fashion to test the proposal that the use of bethanechol chloride would enhance return of bladder function and shorten postoperative catheter time. Forty-nine patients who underwent an anterior repair, Burch colposuspension or Marshall-Marchetti-Krantz (MMK) procedure were preoperatively randomized to one of two catheter clamping protocols. Protocol I involved a continuous clamping regimen with residuals measured with each void. Protocol II involved an intermittent clamping (‘bladder training’) regimen with residuals measured at specified intervals while the catheter was in place. Each patient received either bethanechol chloride or placebo in identical capsules. Protocol I significantly shortened the duration of postoperative catheterization (P<0.01). The use of bethanechol chloride prolonged the duration of catheterization in Protocol I patients and made no difference in Protocol II patients. We would recommend our simplified catheter protocol and the avoidance of bethanechol chloride in the management of indwelling catheters after surgery for urinary incontinence.
Tài liệu tham khảo
Hodgkinson CP, Hodari A. Trocar suprapubic cystotomy for postoperative bladder drainage. Am J Obstet Gynecol 1966; 96: 773–783
Mattingly RF, ed. TeLinde's operative gynecology, 5th edn. Philadelphia: J B Lippincott, 1977: 87–89
Broberg C. Catheter drainage after gynecologic surgery: a comparison of methods. Am J Obstet Gynecol 1984; 149: 18–23
Ostergard DR, ed. Gynecologic urology and urodynamics, 2nd edn. Baltimore: Williams and Wilkins, 1985: 347–348
Finkbeiner AE. Is bethanechol chloride clinically effective in promoting bladder emptying? A literature review. J Urol 1985; 134: 443–449
Barrett DM. The effect of oral bethanechol chloride on voiding in female patients with excessive residual urine: a randomized doubleblind study. J Urol 1981; 126: 640–642
Sonda PI, Gershon C, Diokno AC, Lapides J. Further observations of the cystometric and uroflowmetric effects of bethanechol chloride on the human bladder. J Urol 1979; 122: 775–777
Bergman A, Matthews L, Ballard CA. Bladder training after surgery for stress incontinence: it is necessary? Obstet Gynecol 1987; 70: 909–912