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Systematic review of shorter versus longer duration of bladder catheterization after surgical repair of urinary obstetric fistula
Author(s) -
Torloni M. Regina,
Riera Rachel,
Rogozińska Ewelina,
Tunçalp Özge,
Gülmezoglu A. Metin,
Widmer Mariana
Publication year - 2018
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12462
Subject(s) - medicine , relative risk , urinary catheterization , urinary incontinence , fistula , urinary system , urinary bladder , surgery , urinary fistula , confidence interval , randomized controlled trial , urinary retention
Abstract Background Bladder catheterization duration after urinary obstetric fistula surgery varies widely. Objective To assess the effect of bladder catheterization duration after urinary obstetric fistula surgery. Search strategy Medline, EMBASE , CINAHL , GIM , and POPLINE databases were searched, without language restrictions, using “obstetric urinary fistula” and “catheterization” from inception to September 30, 2017. Selection criteria Randomized controlled trials comparing shorter versus longer (>10 days) bladder catheterization after urinary obstetric fistula repair were included. Data collection and analysis Data were extracted and meta‐analyses were conducted. The GRADE system was used to assess evidence quality. Main results Two unblinded non‐inferiority trials (684 patients combined) were included. There were no differences between shorter and longer bladder catheterization in the risk of fistula repair breakdown either before (relative risk [ RR ] 1.14; 95% confidence interval [ CI ] 0.49–2.64) or after ( RR 1.64; 95% CI 0.81–3.31) hospital discharge. Similarly, urinary infection ( RR 5.18; 95% CI 0.25–107.44); urinary incontinence before ( RR 1.15; 95% CI 0.54–2.43) or after ( RR 1.16; 95% CI 0.62–2.18) discharge; urinary retention ( RR 1.34; 95% CI 0.79–2.27); or extended hospital stay ( RR 9.33; 95% CI 0.51–172.41) were not associated with duration of catheterization. Evidence quality was low or moderate. Conclusions Shorter, compared to longer, bladder catheterization duration after urinary obstetric fistula surgery was not associated with significant outcome differences.