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Suprapubic bladder drainage and epidural catheters following abdominal surgery—A risk for urinary tract infections?

BACKGROUND: Epidural catheters are state of the art for postoperative analgesic in abdominal surgery. Due to neurolysis it can lead to postoperative urinary tract retention (POUR), which leads to prolonged bladder catheterization, which has an increased risk for urinary tract infections (UTI). Our a...

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Autores principales: Wagner, Johanna, Eiken, Barbara, Haubitz, Imme, Lichthardt, Sven, Matthes, Niels, Löb, Stefan, Klein, Ingo, Germer, Christoph-Thomas, Wiegering, Armin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343869/
https://www.ncbi.nlm.nih.gov/pubmed/30673740
http://dx.doi.org/10.1371/journal.pone.0209825
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author Wagner, Johanna
Eiken, Barbara
Haubitz, Imme
Lichthardt, Sven
Matthes, Niels
Löb, Stefan
Klein, Ingo
Germer, Christoph-Thomas
Wiegering, Armin
author_facet Wagner, Johanna
Eiken, Barbara
Haubitz, Imme
Lichthardt, Sven
Matthes, Niels
Löb, Stefan
Klein, Ingo
Germer, Christoph-Thomas
Wiegering, Armin
author_sort Wagner, Johanna
collection PubMed
description BACKGROUND: Epidural catheters are state of the art for postoperative analgesic in abdominal surgery. Due to neurolysis it can lead to postoperative urinary tract retention (POUR), which leads to prolonged bladder catheterization, which has an increased risk for urinary tract infections (UTI). Our aim was to identify the current perioperative management of urinary catheters and, second, to identify the optimal time of suprapubic bladder catheter removal in regard to the removal of the epidural catheter. METHODS: We sent a questionnaire to 102 German hospitals and analyzed the 83 received answers to evaluate the current handling of bladder drainage and epidural catheters. Then, we conducted a retrospective study including 501 patients, who received an epidural and suprapubic catheter after abdominal surgery at the University Hospital Würzburg. We divided the patients into three groups according to the point in time of suprapubic bladder drainage removal in regard to the removal of the epidural catheter and analyzed the onset of a UTI. RESULTS: Our survey showed that in almost all hospitals (98.8%), patients received an epidural catheter and a bladder drainage after abdominal surgery. The point in time of urinary catheter removal was equally distributed between before, simultaneously and after the removal of the epidural catheter (respectively: ~28–29%). The retrospective study showed a catheter-associated UTI in 6.7%. Women were affected significantly more often than men (10,7% versus 2,5%, p<0.001). There was a non-significant trend to more UTIs when the suprapubic catheter was removed after the epidural catheter (before: 5.7%, after: 8.4%). CONCLUSION: The point in time of suprapubic bladder drainage removal in relation to the removal of the epidural catheter does not seem to correlate with the rate of UTIs. The current handling in Germany is inhomogeneous, so further studies to standardize treatment are recommended.
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spelling pubmed-63438692019-02-02 Suprapubic bladder drainage and epidural catheters following abdominal surgery—A risk for urinary tract infections? Wagner, Johanna Eiken, Barbara Haubitz, Imme Lichthardt, Sven Matthes, Niels Löb, Stefan Klein, Ingo Germer, Christoph-Thomas Wiegering, Armin PLoS One Research Article BACKGROUND: Epidural catheters are state of the art for postoperative analgesic in abdominal surgery. Due to neurolysis it can lead to postoperative urinary tract retention (POUR), which leads to prolonged bladder catheterization, which has an increased risk for urinary tract infections (UTI). Our aim was to identify the current perioperative management of urinary catheters and, second, to identify the optimal time of suprapubic bladder catheter removal in regard to the removal of the epidural catheter. METHODS: We sent a questionnaire to 102 German hospitals and analyzed the 83 received answers to evaluate the current handling of bladder drainage and epidural catheters. Then, we conducted a retrospective study including 501 patients, who received an epidural and suprapubic catheter after abdominal surgery at the University Hospital Würzburg. We divided the patients into three groups according to the point in time of suprapubic bladder drainage removal in regard to the removal of the epidural catheter and analyzed the onset of a UTI. RESULTS: Our survey showed that in almost all hospitals (98.8%), patients received an epidural catheter and a bladder drainage after abdominal surgery. The point in time of urinary catheter removal was equally distributed between before, simultaneously and after the removal of the epidural catheter (respectively: ~28–29%). The retrospective study showed a catheter-associated UTI in 6.7%. Women were affected significantly more often than men (10,7% versus 2,5%, p<0.001). There was a non-significant trend to more UTIs when the suprapubic catheter was removed after the epidural catheter (before: 5.7%, after: 8.4%). CONCLUSION: The point in time of suprapubic bladder drainage removal in relation to the removal of the epidural catheter does not seem to correlate with the rate of UTIs. The current handling in Germany is inhomogeneous, so further studies to standardize treatment are recommended. Public Library of Science 2019-01-23 /pmc/articles/PMC6343869/ /pubmed/30673740 http://dx.doi.org/10.1371/journal.pone.0209825 Text en © 2019 Wagner et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Wagner, Johanna
Eiken, Barbara
Haubitz, Imme
Lichthardt, Sven
Matthes, Niels
Löb, Stefan
Klein, Ingo
Germer, Christoph-Thomas
Wiegering, Armin
Suprapubic bladder drainage and epidural catheters following abdominal surgery—A risk for urinary tract infections?
title Suprapubic bladder drainage and epidural catheters following abdominal surgery—A risk for urinary tract infections?
title_full Suprapubic bladder drainage and epidural catheters following abdominal surgery—A risk for urinary tract infections?
title_fullStr Suprapubic bladder drainage and epidural catheters following abdominal surgery—A risk for urinary tract infections?
title_full_unstemmed Suprapubic bladder drainage and epidural catheters following abdominal surgery—A risk for urinary tract infections?
title_short Suprapubic bladder drainage and epidural catheters following abdominal surgery—A risk for urinary tract infections?
title_sort suprapubic bladder drainage and epidural catheters following abdominal surgery—a risk for urinary tract infections?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343869/
https://www.ncbi.nlm.nih.gov/pubmed/30673740
http://dx.doi.org/10.1371/journal.pone.0209825
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