How the Method of Bladder Emptying After Epidural Placement in Labor Affects Postpartum Voiding

NCT07125326 — Not applicable, Active not recruiting, 300 participants, University of Pittsburgh

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Intermittent Versus Continuous Bladder Catheterization in Epiduralized Laboring Patients: a Non-blinded Randomized Controlled Trial

Registry	NCT07125326
Status	Active not recruiting
Phase	Not applicable
Study type	Interventional; randomized, parallel, masking: double, prevention
Enrollment	300 (Actual)
Sponsor	University of Pittsburgh (Other)
Conditions	Urinary Retention, Urinary Tract Infection (Diagnosis), Postpartum Acute Urinary Retention, Postpartum Care, Voiding Dysfunction
Interventions	Intermittent catheterization, Continuous catheterization (Procedure)
Dates	start 2025-12-09, primary completion 2026-05-21, completion 2027-05-21 (estimated), first posted 2025-08-15, last updated 2026-06-12
Locations	1 site in United States

-Summary

At least ten percent of patients have postpartum urinary retention or difficulty urinating after birth, which can cause incontinence and other urinary problems long-term. After getting an epidural placed, patients should be numb in their pelvic region. This numbness makes it difficult to feel the need to urinate, so patients need a urinary catheter placed to empty the bladder. Some patients have one catheter placed throughout their labor and others have a catheter placed to empty the bladder then removed every few hours. The investigators are studying whether placing a catheter once or catheterizing multiple times affects the rate of postpartum urinary problems and infection.

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+Detailed description

This is a randomized controlled trial to assess the effect of bladder catheterization method during labor with epidural anesthesia on the rate of postpartum urinary retention.

+Arms and interventions

Arm	Type	Interventions	Description
Intermittent catheterization	Active comparator	Procedure: Intermittent catheterization
Continuous catheterization	Active comparator	Procedure: Continuous catheterization

Intermittent catheterization (Procedure): intermittent bladder catheterization every four hours, or shorter intervals if volume exceeds 500mL per expert recommendation
Continuous catheterization (Procedure): One catheter is placed in the bladder until pushing

+Outcome measures

Primary outcomes

Postpartum urinary retention [Three days postpartum]: Urinary retention defined as overt inability to void at six hours after last bladder emptying postpartum or symptomatic incomplete emptying, or covert retention of >150cc urine in the bladder after voiding Collecting number of participants who experience this

Secondary outcomes

Postpartum urinary tract infection [One week postpartum]: Culture-proven urinary tract infection without pre-existing infection documented on admission for delivery Collecting number of participants who experience this
Patient satisfaction [Immediately postpartum]: Title: Patient satisfaction Minimum rating 1, maximum 5, with 5 corresponding to better outcome Each question will be interpreted alone rather than aggregated
Nurse satisfaction [Immediately postpartum]: Title: Nurse satisfaction Minimum rating 1, maximum 5, with 5 corresponding to better outcome Each question will be interpreted alone rather than aggregated
Voiding function at 2 weeks [2 weeks postpartum]: Urinary Distress Inventory-6 questionnaire answers, to be analyzed individually (0-4) and also summed, with higher total score indicating worse function from 0 to 24
Voiding function at 6 weeks [6 weeks postpartum]: Urinary Distress Inventory-6 questionnaire answers, to be analyzed individually (0-4) and also summed, with higher total score indicating worse function from 0 to 24
Voiding function at 6 months [6 months postpartum]: Urinary Distress Inventory-6 questionnaire answers, to be analyzed individually (0-4) and also summed, with higher total score indicating worse function from 0 to 24
Voiding function at one year [one year postpartum]: Urinary Distress Inventory-6 questionnaire answers, to be analyzed individually (0-4) and also summed, with higher total score indicating worse function from 0 to 24

+Eligibility

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Pregnant patients planning vaginal delivery presenting in labor or for induction of labor
* Age 18 years and older
* Live fetus
* Receive epidural anesthesia

Exclusion Criteria:

* those under 18 years old
* those with stillbirth
* those with baseline overactive bladder symptoms, neurogenic bladder diagnoses, or otherwise using bladder catheterization during pregnancy

Patients will be excluded from UTI analyses if:

* they received antibiotics intrapartum
* had bacteriuria diagnosed by a clean catch specimen showing >100,000 CFU/mL of a single bacterial species, regardless of symptoms

+Locations (1)

Facility	City	Country	Status
UPMC Magee-Womens Hospital	Pittsburgh, Pennsylvania	United States

+Investigators

Anna Binstock, MD, Study chair, UPMC Magee-Womens Hospital