WHO recommends 7–10 day bladder catheterisation for obstetric

complicationNew Delhi, Jan 14 (PTI) The WHO has issued a newguideline recommending a 7–10 day period of bladdercatheterisation for an obstetric c...

complicationNew Delhi, Jan 14 (PTI) The WHO has issued a newguideline recommending a 7–10 day period of bladdercatheterisation for an obstetric complication more common inSouth Asia and sub-Saharan Africa.

The World Health Organisation (WHO) recommendation on thenumber of days of bladder catheterisation following surgicalrepair is for simple obstetric urinary fistula.

Currently the length of catheterisation is not standardand ranges from 5 to 42 days.

"The new guidance recommends a 7–10 day period of bladdercatheterisation to allow complete healing," the global healthbody said.

Obstetric fistula is an abnormal opening between awoman's genital tract and her urinary tract or rectum.

When the mother's pelvis is too narrow or the baby is toolarge or in an abnormal position, labour can last for severaldays and often results in the death of the baby or the mother.

If the mother survives, she could develop a fistula. Shemay be unable to control her rectal or urinary functions.

"Longer periods of catheterisation can be inconvenientfor the woman, her family and care providers as it isassociated with more discomfort and inconvenience.

"It also increases the risk of infection and erosionrelated to catheterisation, requires more intensive nursingcare and costs more per patient," the WHO said.

Obstetric fistula occurs primarily in sub-Saharan Africa(1.6 cases per 1,000 women) and South Asia (1.2 cases per1,000 women).

Mostly it can be repaired surgically and catheterisationis important to allow tension-free healing of the surgicalscar.

"As part of the WHO's normative work on supportingevidence-informed policies and practices, the Department ofReproductive Health and Research has produced a new guidelinethat defines the length of time required for effectivecatheterisation after the surgical repair of simple obstetricurinary fistula as a period of 7–10 days," the WHO said.

The global health body said that it is an interventionthat can be implemented by any appropriately trained surgeon,including one with less experience, and it has direct healthand cost implications in low-and middle-income countries.

Shorter periods of post-operative bladder catheterisationhave been tested in simple cases of obstetric fistula andshown to be effective in allowing complete healing withimproved patient comfort and potentially lower risks ofcatheter-related urinary tract infections, it said.

The WHO said this in turn means less intensive nursingcare is required, shorter hospital stays and thus reducedcosts for the health system.

"With shorter stays in hospital it should be possible toincrease the number of fistula patients who could receivetreatment using the existing facilities," it said. PTI TDS ASKASK.

This is unedited, unformatted feed from the Press Trust of India wire.

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