Meixuan Li1,2,3,4, Xin Xing5, Liang Yao6, Xiaoqin Wang2,3,4, Wenbo He1, Meng Wang1, Huijuan Li1,2,3,4, Yangqin Xun1,2,3,4, Peijing Yan7, Xu Hui1, Xinmin Yang8, Kehu Yang9,10,11,12,13. 1. School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China. 2. Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China. 3. Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, 730000, China. 4. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China. 5. Gansu University of Traditional Chinese Medicine, Lanzhou, 730000, China. 6. Chinese Medicine Faculty of Hong Kong Baptist University, Hong Kong, 999077, China. 7. Institute of Clinical Research and Evidence Based Medicine, The Gansu Provincial Hospital, Lanzhou, 730000, China. 8. Department of Endoscopic Surgery, Chinese PLA Hospital, Xi'an, 710054, China. yanxm200816@163.com. 9. School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China. kehuyangebm2006@126.com. 10. Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China. kehuyangebm2006@126.com. 11. Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, 730000, China. kehuyangebm2006@126.com. 12. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China. kehuyangebm2006@126.com. 13. Institute of Clinical Research and Evidence Based Medicine, The Gansu Provincial Hospital, Lanzhou, 730000, China. kehuyangebm2006@126.com.
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.
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.
Authors: Gordon H Guyatt; Andrew D Oxman; Holger J Schünemann; Peter Tugwell; Andre Knottnerus Journal: J Clin Epidemiol Date: 2010-12-24 Impact factor: 6.437