Elective caesarean section without routine indwelling bladder catheterization – impact on mobilization and patient satisfaction
4 affiliations
- 1Department of obstetrics and gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- 2Department of Obstetrics and gynaecology, HUCH/Women’s hospital, Haartmaninkatu 2, PO BOX 140, HUS, FI-00029 Finland
- 3Department of Anaesthesiology and Intensive care, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
- 4University of Eastern Finland, Kuopio, Finland
Abstract
Background: Global caesarean section rates have continuously increased. Therefore, a remarkable number of women could benefit from Enhanced Recovery After Surgery (ERAS®) protocol aiming to reduce perioperative stress and achieve early recovery. In 2019 the ERAS® protocol for caesarean section was initiated in the Helsinki University Women’s Hospital and the Espoo Delivery Hospital in Finland. Among other improvements, the routine use of indwelling urinary catheter was discontinued among healthy women with no significant preoperative risk factors.
Methods: This retrospective case-control study was carried out at the Espoo Hospital in Finland. Data were collected retrospectively from the hospital’s electronic patient information system. The study included 208 women undergoing full term elective caesarean section. Group 1 (n = 104) routinely had an indwelling urinary catheter placed: half of them had no pre-specified time for catheter removal (n = 52) and half of them had an indwelling urinary catheter placed for 8 to 12 h (n = 52). Group 2 (n = 104) had a perioperatively placed urinary catheter only if needed. The primary outcome was the time from the end of the operation to patient mobilization, while secondary outcomes were the length of hospital stay and overall patient satisfaction.
Results: Group 2 without a routine indwelling urinary catheter had a significantly shorter median time to mobilization (median = 5.8 h) than group 1 (median = 9.1 h) p < 0.001. In the multivariable analysis, the absence of the urinary catheter was the strongest factor associated with earlier mobilization. There was no difference in length of hospital stay, patient satisfaction or intraoperative blood loss between the groups and no bladder injuries were recorded.
Conclusion: Patients without a routine indwelling urinary catheter mobilized significantly faster compared to patients with a routinely placed urinary catheter. We found no difference in length of stay or patient satisfaction between the groups. These results support limiting the routine use of indwelling urinary catheter among healthy women undergoing caesarean section.
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BibTeX
@article{ilonen2026elective,
title = {{Elective caesarean section without routine indwelling bladder catheterization – impact on mobilization and patient satisfaction}},
author = {Anni Ilonen and Antti Väänänen and Antti Puhakka and Hanna Vihervaara and Marja Kaijomaa},
journal = {BMC Pregnancy and Childbirth},
year = {2026},
month = aug,
doi = {10.1186/s12884-026-09763-1},
url = {https://doi.org/10.1186/s12884-026-09763-1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Elective caesarean section without routine indwelling bladder catheterization – impact on mobilization and patient satisfaction
AU - Anni Ilonen
AU - Antti Väänänen
AU - Antti Puhakka
AU - Hanna Vihervaara
AU - Marja Kaijomaa
PY - 2026
DA - 2026/08/08
JO - BMC Pregnancy and Childbirth
DO - 10.1186/s12884-026-09763-1
UR - https://doi.org/10.1186/s12884-026-09763-1
AB - Background: Global caesarean section rates have continuously increased. Therefore, a remarkable number of women could benefit from Enhanced Recovery After Surgery (ERAS®) protocol aiming to reduce perioperative stress and achieve early recovery. In 2019 the ERAS® protocol for caesarean section was initiated in the Helsinki University Women’s Hospital and the Espoo Delivery Hospital in Finland. Among other improvements, the routine use of indwelling urinary catheter was discontinued among healthy women with no significant preoperative risk factors. Methods: This retrospective case-control study was carried out at the Espoo Hospital in Finland. Data were collected retrospectively from the hospital’s electronic patient information system. The study included 208 women undergoing full term elective caesarean section. Group 1 (n = 104) routinely had an indwelling urinary catheter placed: half of them had no pre-specified time for catheter removal (n = 52) and half of them had an indwelling urinary catheter placed for 8 to 12 h (n = 52). Group 2 (n = 104) had a perioperatively placed urinary catheter only if needed. The primary outcome was the time from the end of the operation to patient mobilization, while secondary outcomes were the length of hospital stay and overall patient satisfaction. Results: Group 2 without a routine indwelling urinary catheter had a significantly shorter median time to mobilization (median = 5.8 h) than group 1 (median = 9.1 h) p < 0.001. In the multivariable analysis, the absence of the urinary catheter was the strongest factor associated with earlier mobilization. There was no difference in length of hospital stay, patient satisfaction or intraoperative blood loss between the groups and no bladder injuries were recorded. Conclusion: Patients without a routine indwelling urinary catheter mobilized significantly faster compared to patients with a routinely placed urinary catheter. We found no difference in length of stay or patient satisfaction between the groups. These results support limiting the routine use of indwelling urinary catheter among healthy women undergoing caesarean section.
SN - 1471-2393
ER -