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International Urogynecology Journal

, Volume 30, Issue 9, pp 1419–1427 | Cite as

The effect of bladder catheterization on the incidence of urinary tract infection in laboring women with epidural analgesia: a meta-analysis of randomized controlled trials

  • Meixuan Li
  • Xin Xing
  • Liang Yao
  • Xiaoqin Wang
  • Wenbo He
  • Meng Wang
  • Huijuan Li
  • Yangqin Xun
  • Peijing Yan
  • Xu Hui
  • Xinmin YangEmail author
  • Kehu YangEmail author
Review Article
  • 226 Downloads

Abstract

Introduction and hypothesis

There is conflicting evidence on whether intermittent catheterization (IC) is less associated with urinary tract infection (UTI) and more likely to prevent urinary retention than continuous catheterization (CC). We aimed to compare the effect of IC with that of CC on the incidence of postpartum UTI, urinary retention and hemorrhage in laboring women with epidural analgesia.

Methods

Electronic searches were performed in PubMed, EMBASE and Cochrane Library from their inception to October 2018. We selected RCTs comparing IC with CC in laboring women with epidural analgesia. A meta-analysis was performed using the RevMan software, and a random-effects model was used to pool the effect size. The Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used to rate the quality of evidence.

Results

Six RCTs (N = 850) were included in this review. The meta-analyses indicated that there was no significant difference between the IC and CC group in the incidence of postpartum UTI (RR = 1.25, 95% CI: 0.91 to 1.71, P = 0.16), postpartum urinary retention (RR = 0.76, 95% CI: 0.21 to 2.77, P = 0.68) and postpartum hemorrhage (RR = 1.72, 95% CI: 0.60 to 4.95, P = 0.31). GRADE assessment results showed that the quality of evidence was low.

Conclusions

Based on the available evidence, there is no measurable difference in rates of UTI between CC and IC, not that neither stragety decreases UTI, since the included trials do not address this.

Keywords

Labor Epidural analgesia Urinary catheter Continuous catheterization Intermittent catheterization Bladder drainage 

Abbreviations

IC

Intermittent catheterization

CC

Continuous catheterization

UTI

Urinary tract infection

RCT

Randomized clinical trial

RR

Risk ratio

CI

Confidence interval

GRADE

Grades of Recommendation, Assessment, Development and Evaluation

Notes

Acknowledgements

The authors thank Jinhui Tian and all members of the Evidence-Based Medicine Center, Lanzhou University, for their help with this study.

Compliance with ethical standards

Conflicts of interest

None.

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Copyright information

© The International Urogynecological Association 2019

Authors and Affiliations

  1. 1.School of Public HealthLanzhou UniversityLanzhouChina
  2. 2.Evidence Based Medicine Center, School of Basic Medical SciencesLanzhou UniversityLanzhouChina
  3. 3.Evidence Based Social Science Research CenterLanzhou UniversityLanzhouChina
  4. 4.Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu ProvinceLanzhouChina
  5. 5.Gansu University of Traditional Chinese MedicineLanzhouChina
  6. 6.Chinese Medicine Faculty of Hong Kong Baptist UniversityHong KongChina
  7. 7.Institute of Clinical Research and Evidence Based MedicineThe Gansu Provincial HospitalLanzhouChina
  8. 8.Department of Endoscopic SurgeryChinese PLA HospitalXi’anChina

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