@2024 Afarand., IRAN

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ISSN: 2252-0805    The Horizon of Medical Sciences 2015;20(4):215-221

Background
… [1-5] Urinary retention after surgery is the conscious patient’s incapability to urinate in 4-6 hours after surgery [6]. Catheterization of the bladder, if it causes some injuries, makes the patient capable of infections, stenosis, retraction, and bleeding in the urinary tract [6]. … [7-15] Based on the principles of reflexology, pressure on a foot reflex point can affect all the organs [16-18]. … [19-23]
Previous Studies
Feet reflexology massage has been studied as a non-invasive nursing intervention in different conditions. The studies show recoveries in migraine headaches [24], breath problems [25], blood flow [26, 27], and high blood pressure and insomnia [30], and lower pain, anxiety, and stress [28, 29], as well as treating some prevalent pregnancy problems [31] and affecting time and volume of the first urine repulse in women after selective Caesarian surgery without urine catheter [32].
Aim(s)
The aim of this study was to study the effects of feet reflexology massage on urinary retention relieving after surgery.
Research type
This is a randomized clinical trial with control group.
Research society, place and time
Patients with urinary retention after surgery were studied at the surgery ward of 15 Khordad Hospital of Bidakht (Iran) in 2014.
Sampling method and number
Based on the mean comparison formula, the sample size for each group was estimated 70 persons. Sampling was done through random allocation with permutation blocks method.
Used devices&materials
The samples were divided into two equal groups including experiment and control. The inclusion criteria included the patient’s self-report of urinary retention after non-urgent surgery despite of the need for repulse half an hour after surgery or urinary retention after surgery for 6 hours without feeling the need for repulse. Other inclusion criteria were full consciousness, ability for communication and reporting the symptoms and their severity, 18 years old and beyond, no history of renal failure, urethral catheterization, urinary tract stones, urinary tract infections, urethral stricture and benign grow of prostate, no history of neurological disease, neuropathy due to diabetes or alcohol, cerebral palsy, multiple sclerosis, spinal cord injury and surgery on the nervous system, and no fracture, wound, skin problem and plaster in the location of foot massage. The exclusion criteria were intolerance of the intervention and failure to continue. After routine activities to stimulate the repulse, the volume of the retained urine was measured. To control the retained urine volume in the bladder, to adapt it with the definition of urinary retention, and to control it as an intervening factor, the volumes of the repulsed urine in both groups were measured and compared with each other. Sampling was done in patients with urinary retention after surgery, and they could not repulse after routine nursing interventions without bladder catheterization. Data was collected, using demographic information questionnaire, a checklist for investigating the inclusion criteria to select the study units, and a register form to record the results of the interventions. 1min feet general massage was done. In experiment group, feet reflexology massage was done up to 30min (15min for each foot) on the bladder-point on foot [13]. In control group, feet placebo massage was done up to 30min (15 min for each foot). In both groups, if until 6 hours there was no ability for repulse despite the mentioned activities, the patients were catheterized [13]. Data was recorded on the information record sheet. Data was analyzed, using SPSS 16 software. Independent T test was used to compare the mean ages, weights, blood pressures, pulses, and surgery lengths. Mann-Whitney test was used to compare the volumes of repulse urine, urinary outputs, and lengths of elimination of urinary retention. Chi-square test was used to compare genders, types of anesthesia, types of surgery, elimination of urinary retention, and morphine reception between both groups.
Findings by Text
Mean ages of experiment and control groups were 38.05±17.85 and 37.94±13.82 years, respectively. There was no significant difference in demographic and clinical characteristics between the groups (Table 1). In 27 persons (58.7%) of experiment group and 19 persons (41.3%) of control group urinary retention elimination was observed. Length of the urinary retention elimination in experiment group (30.28±47.89min) was significantly lesser than control group (40.28±29.65). There was no significant difference between mean volumes of repulse urine in experiment group (465.14±229.37) and control group (414.28±222.14).
Main comparison to the similar studies
There was a significant difference between the groups in urinary retention elimination and its length without catheterization. 20-minute feet reflexology massage on pituitary, kidneys, and bladder points 2-3 hours after Caesarian surgery leads to a shorter time and lower volume of the first urine repulse without catheter after surgery than control group with feet surface massage [32]. … [33-36] 20-minute reflexology massage on the kidneys, bladder, and urinary tract points in a delivery person with pliers tool, who has been unable to repulse urine after removing urine catheter, leads to feel pressure in the bladder and repulsion of about 1.5lit urine during half an hour [37]. The result is consistent with the present result. The utilization of methods such as water sound, warm air flow, and bladder massage are successful up to 75% [38]. In the present study, opening the water tap and putting warm water sack on the bladder for 20min was successful up to 41.3%. There is removal of urinary retention after putting warm water sack and early leaving the bed in 77% of patient under general surgery [12], which is higher than the present success. 10- to 30-minute urine repulse by reflexology massage compared to 30-minute repulse by water sound, warm air flow, and bladder massage methods is consistent with the present results [38]. Feet reflexology massage in women after selective Caesarian surgery without urinary catheter leads to a significant decrease in the elimination time of urinary retention [32]. The result is consistent with the present results. Mean volumes of urine repulsion in experiment and control groups were 400ml and 300ml, respectively. In addition, there was no significant difference between the groups. 20-minute feet reflexology massage on pituitary, kidneys, and bladder points 2-3 hours after surgery leads to a significant difference in the volume of the first urine repulse after surgery than feet surface massage [32]. Feet reflexology massage can be more effective on blood flow increase and producing more urine [27]. … [39]
Suggestions
Training the reflexology massage to the nurses with its applications in the surgery wards should be noticed.
Limitations
The patient’s self-report of urinary retention after surgery and no application of sonography methods or bladder scan, no study about the effects of feet reflexology massage before other interventions or simultaneously, and lack of any control on repulse model and other intervention consequences after surgery were of the limitations for the study.
Conclusions
Feet reflexology massage is effective on urinary retention after surgery.
Acknowledgments
All the participants, staff of Bidakht 15 Khordad Hospital, and Education and Research Deputies of Gonabaad University of Medical Sciences are appreciated.
Conflict of interest
Non-declared
Ethical Permissions
Ethics Committee of Gonabaad University of Medical Sciences confirmed the study.
Funding Sources
Research and Technology Deputy of Gonabaad University of Medical Sciences funded the study.

TABLES and CHARTS

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