Effect of Voiding Position (Standing in the Shower vs. Sitting) on Post- Void Residual Urine Volume (PVR) After Removal of Urinary Catheter in Women Following Vaginal Delivery With Epidural Analgesia: A Double- Blind Randomized Controlled Trial

NCT07893119 | Not Yet Recruiting

• 1 other identifier: AAA-0180-25
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

Postpartum urinary retention is a common complication after childbirth, with a higher risk for women who undergo vaginal delivery with epidural analgesia. This study aims to determine whether performing the first void after the removal of an indwelling urinary catheter in a standing position in the shower, compared to sitting on a toilet, helps reduce postpartum urinary retention. The study will include 100 women who had a vaginal delivery with epidural analgesia. Participants will be randomly assigned to either void while standing in the shower (Group A) or sitting on the toilet (Group B). Immediately after this first spontaneous void, the post-void residual urine volume (PVR) will be measured using an ultrasound bladder scan. The study seeks to find out if the standing position facilitates more complete bladder emptying, reduces the need for recatheterization, and decreases perineal pain compared to the sitting position.

Conditions

Postpartum Urinary Retention

Keywords

Postpartum Urinary Retention; Vaginal Delivery; Epidural Analgesia; Post-Void Residual Volume; Urinary Catheter

Outcome Measures

Primary Outcomes (1)

• Number of participants with Post-Void Residual Volume (PVR) > 150 mL

  Post-void residual urine volume (PVR) greater than 150 mL, measured by bladder ultrasound (bladder scan) immediately after the first spontaneous void following catheter removal. This cut-off is consistent with definitions of covert postpartum urinary retention.

  Immediately after the first void (within a maximum of 6 hours following catheter removal)

Secondary Outcomes (7)

• Mean Post-Void Residual Volume (PVR)

  Immediately after the first void (within a maximum of 6 hours following catheter removal)

• Incidence of Overt Postpartum Urinary Retention (PUR)

  Up to 6 hours after catheter removal

• Need for Recatheterization

  Within 24-48 hours postpartum

• Time to First Void

  Up to 6 hours after catheter removal

• Incidence of Urinary Tract Infection (UTI)

  Within 7 days postpartum

Study Arms (2)

Group A - Standing Position

EXPERIMENTAL

Participants will perform their first void after catheter removal in a standing position in the shower.

Behavioral: Standing in the shower

Group B - Sitting Position

ACTIVE COMPARATOR

Participants will perform their first void after catheter removal in a sitting position on the toilet.

Behavioral: Sitting on the toilet

Interventions

Standing in the shower BEHAVIORAL

The woman is assisted to the shower area and instructed to void in a standing position under running warm water.

Group A - Standing Position

Sitting on the toilet BEHAVIORAL

he woman is assisted to the toilet and instructed to void in a sitting position.

Group B - Sitting Position

Eligibility Criteria

• Age: 18 Years+
• Gender Eligibility Details: Eligibility is restricted to individuals who have undergone a vaginal delivery
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

Sponsors & Collaborators

• Assuta Ashdod Hospital: lead

Study Sites (1)

ssuta Ashdod Hospital

Ashdod, Israel

Location

Related Publications (3)

• Ellahi A, Stewart F, Kidd EA, Griffiths R, Fernandez R, Omar MI. Strategies for the removal of short-term indwelling urethral catheters in adults. Cochrane Database Syst Rev. 2021 Jun 29;6(6):CD004011. doi: 10.1002/14651858.CD004011.pub4.

  PMID: 34184246 BACKGROUND

• Chou EC, Chang CH, Chen CC, Wu HC, Wu PL, Chen KL. Women urinate in the standing position do not increase post-void residual urine volumes. Neurourol Urodyn. 2010 Sep;29(7):1299-300. doi: 10.1002/nau.20868.

  PMID: 20878999 BACKGROUND

• Yang KN, Chen SC, Chen SY, Chang CH, Wu HC, Chou EC. Female voiding postures and their effects on micturition. Int Urogynecol J. 2010 Nov;21(11):1371-6. doi: 10.1007/s00192-010-1204-3. Epub 2010 Jul 1.

  PMID: 20593163 BACKGROUND

MeSH Terms

Interventions

Standing Position

Intervention Hierarchy (Ancestors)

Posture; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Central Study Contacts

Elad Preuss, M.D

CONTACT

+972545228700; eladp@ashmc.co.il

Amit Markovich, M.D

CONTACT

+972504476677; amitwendy31@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: Due to the obvious nature of the physical intervention (voiding position), participants and the staff assisting with voiding cannot be blinded. Masking is strictly applied to the healthcare professionals performing and recording the post-void residual (PVR) ultrasound measurements (outcomes assessors), as well as the investigators performing the data analysis.
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Participants will be randomized in a 1:1 ratio using a computer-generated sequence to one of two parallel groups just prior to the removal of their indwelling urinary catheter.

Study Record Dates

• First Submitted: October 19, 2026
• First Posted: October 23, 2026
• Study Start: October 20, 2026
• Primary Completion (Estimated): August 1, 2029
• Study Completion (Estimated): December 1, 2029
• Last Updated: October 23, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

IL (1)