Prevalence of Urinary Tract Infection due to Urinary Catheterization in Obstetric and Gynaecological Operations

Authors

  • Jesmin Akter Professor Dr. Jesmin Akter, Professor, Department of Obstetrics and Gynaecology, Medical College for Women and Hospital, Uttara, Dhaka, Bangladesh
  • Ahmad Seraji Associate Professor and Head, Department of Burn, Plastic and Reconstructive Surgery, Shaheed Suhrawardy Medical College and Hospital, Dhaka, Bangladesh
  • Lutfun Nahar Associate Professor, Department of Anatomy, Z. H. Sikder Women’s Medical College, Dhaka, Bangladesh
  • Shahriar Islam Khan Assistant Registrar, Department of Neurosurgery, Uttara Adhunik Medical College Hospital, Uttara, Dhaka, Bangladesh
  • Md Redwan Ahsanullah Honorary Medical Officer, Department of Burn, Plastic and Reconstructive Surgery, Shaheed Suhrawardy Medical College and Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.3329/bjms.v18i4.42871

Keywords:

Catheterization; Hysterectomy; Caesarean section UTI

Abstract

Background: Urinary catheterization is routinely done in major gynaecological and obstetric operations in our country. It has some advantages and disadvantages of its own. Among the advantages, it can significantly prevent retention of urine, help in measuring urinary output, avoid discomfort due to full bladder, prevent postpartum hemorrhage and reduce spinal headache due to reduced movements. On the other hand, it can be a constant source of urethral irritation leading to UTI and can cause urethral strictures. So, a quantitative research is necessary to determine the relationship between urinary catheterization and UTI, for establishing a guideline for judicious catheterization.

Methods: Between January 2010 and December 2011, data was collected for conducting an cross-sectional observational study on 49 subjects undergoing various gynaecological and obstetric operations. Precatheterization urine for routine and culture-sensitivity findings were recorded and compared with catheter tip culture and sensitivity after removal. Besides, other factors e.g. clinical history, comorbidity status, hemoglobin status, duration of catheterization, nature of operation etc was brought into consideration.

Results: Patients having urinary catheters for more than 5 days, were found to be more than twice as likely to be developing UTI in various operations, than the patients having catheter for one day. Preoperative albuminuria was also found to be a likely predisposing factor, as the percentage of patients with UTI who had preoperative albuminuria was double compared to the preoperative albuminuria negative patients. The direct relationship between nature of operation and development of post-catheterization UTI was difficult to establish, because of the duration of catheterization acting as a confounding variable.

Conclusion: In most cases of LUCS and hysterectomy, catheter-associated complications can be overcome by avoiding catheterization altogether. This can be better achieved by encouraging the patient to void their bladder immediately before surgery. In long and complicated operations, catheterization cannot be avoided but the postoperative duration of catheterization can be reduced to avoid complications. Moreover, preoperative optimization of comorbid status, hemoglobin status, albuminuria etc can bring forth a favourable outcome in terms of catheterassociated complications.

Bangladesh Journal of Medical Science Vol.18(4) 2019 p.696-702

Downloads

Abstract
103
PDF
77

Downloads

Published

2019-08-30

How to Cite

Akter, J., Seraji, A., Nahar, L., Khan, S. I., & Ahsanullah, M. R. (2019). Prevalence of Urinary Tract Infection due to Urinary Catheterization in Obstetric and Gynaecological Operations. Bangladesh Journal of Medical Science, 18(4), 696–702. https://doi.org/10.3329/bjms.v18i4.42871

Issue

Vol. 18 No. 4 (2019)

Section

Original Articles

License

Authors who publish in the Bangladesh Journal of Medical Science agree to the following terms that:

  1. Authors retain copyright and grant Bangladesh Journal of Medical Science the right of first publication of the work.

  2. Creative Commons Licence
    Articles in Bangladesh Journal of Medical Science are licensed under a Creative Commons Attribution 4.0 International License CC BY-4.0.This license permits use, distribution and reproduction in any medium, provided the original work is properly cited.
  3. Authors are able to enter into separate, additional contractual arrangements for the distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  4. Authors are permitted to post their work online (e.g., in institutional repositories or on their website) as it can lead to productive exchanges, as well as greater citation of published work.