Duration of Urinary Catheterization Following Cesarean Deliveries Under Neuraxial Anesthesia

NCT06881849 | Not Yet Recruiting

• 1 other identifier: H24-03410
• Study Type: observational
• Target: 300
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Cesarean Delivery; Urinary Catheterization

Keywords

patient recovery; cesarean delivery; urinary catheterization; foley catheter; patient anxiety

Outcome Measures

Primary Outcomes (1)

• Correlation between duration of urinary catheterization and STAI-S score

  The STAI-S scale measures the respondents current state of anxiety by using terms to evaluate subjective feelings of worry, apprehension, concern, and nervousness. The scoring is 20-37 to indicate low anxiety, 38-44 to indicate moderate anxiety, and 45-80 to indicate high anxiety.

  From the time of enrollment until urinary catheter removal, assessed up to 24 (+/- 8) postpartum.

Secondary Outcomes (4)

• Timing of delivery

  From urinary catheter placement until its removal, assessed up to 24 (+/- 8) hours postpartum, categorized based on delivery time (e.g., morning: 06:00-11:59, afternoon: 12:00-17:59, evening/night: 18:00-05:59)

• Neuraxial Technique

  From urinary catheter placement until its removal, assessed up 24 (+/- 8) hours postpartum, categorized by neuraxial technique used during delivery

• Opioid Dose

  From urinary catheter placement until its removal, assessed up to 24 (+/- 8) hours postpartum, categorized by total neuraxial opioid dose administered.

• Nursing Perception

  Survey completed by the patient's postpartum nurse within 24 (+/- 8) hours after urinary catheter removal.

Eligibility Criteria

• Age: 19 Years+
• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patient's who underwent a cesarean delivery at BC Women's Hospital.

You may qualify if:

• 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.

You may not qualify if:

• 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.

Sponsors & Collaborators

• University of British Columbia: lead

Study Sites (1)

BC Women's Hospital

Vancouver, British Columbia, V6H 3N1, Canada

Location

Related Publications (6)

• Figueiredo B, Conde A. Anxiety and depression in women and men from early pregnancy to 3-months postpartum. Arch Womens Ment Health. 2011 Jun;14(3):247-55. doi: 10.1007/s00737-011-0217-3. Epub 2011 Apr 9.

  PMID: 21479759 BACKGROUND

• Julian LJ. Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11(0 11):S467-72. doi: 10.1002/acr.20561. No abstract available.

  PMID: 22588767 BACKGROUND

• Goodman JH, Watson GR, Stubbs B. Anxiety disorders in postpartum women: A systematic review and meta-analysis. J Affect Disord. 2016 Oct;203:292-331. doi: 10.1016/j.jad.2016.05.033. Epub 2016 Jun 1.

  PMID: 27317922 BACKGROUND

• Sutherland E, Yang T, Chau A. Duration of Urinary Catheterization After Cesarean Deliveries: A Retrospective Cohort Study..Poster session presented at: 2023 Summer Student Poster Day; 2023 Jul 27; Chieng Family Atrium, BC Children's Research Institute

  BACKGROUND

• Bollag L, Lim G, Sultan P, Habib AS, Landau R, Zakowski M, Tiouririne M, Bhambhani S, Carvalho B. Society for Obstetric Anesthesia and Perinatology: Consensus Statement and Recommendations for Enhanced Recovery After Cesarean. Anesth Analg. 2021 May 1;132(5):1362-1377. doi: 10.1213/ANE.0000000000005257.

  PMID: 33177330 BACKGROUND

• Basbug A, Yuksel A, Ellibes Kaya A. Early versus delayed removal of indwelling catheters in patients after elective cesarean section: a prospective randomized trial. J Matern Fetal Neonatal Med. 2020 Jan;33(1):68-72. doi: 10.1080/14767058.2018.1487394. Epub 2018 Jul 18.

  PMID: 29886771 BACKGROUND

Study Officials

• Anton Chau, MD MMSc

  University of British Columbia

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Aislynn L. Sharrock, BA (Hons)

CONTACT

604-875-2158; aislynn.sharrock@cw.bc.ca

Juliana Barrera, MD MSc FRCPC

CONTACT

604-875-6076; juliana.barrera@cw.bc.ca

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Clinical Associate Professor

Study Record Dates

• First Submitted: February 13, 2025
• First Posted: March 18, 2025
• Study Start: April 25, 2025
• Primary Completion: July 30, 2025
• Study Completion: December 1, 2025
• Last Updated: March 18, 2025

Record last verified: 2025-03

Locations

CA (1)