Haemorrhoids are a common chronic anorectal disease, and haemorrhoidectomy is the standard treatment for advanced (grade III and IV) haemorrhoids. Warm water sitz has commonly been used to stimulate urination, cleanse wounds, and decrease pain. Although urinary retention and pain usually occur within the first 24 h after surgery, the warm water sitz bath is provided 24 h after haemorrhoidectomy, which might be a missed opportunity to optimize the quality and efficiency of the care provided. To investigate the effect of early warm water sitz bath on the day of haemorrhoidectomy surgery on preventing urinary retention and reducing wound pain. This was a longitudinal double-blind study with a permuted block randomization design. This study was conducted in a surgical ward of a medical center. An average of 18 patients receiving hemorrhoid surgery in that ward every month. A total of 64 participants (32 each in the experimental and control groups) were enrolled. (The first recruitment date is January 16, 2020.) Patients who received haemorrhoidectomy for grade III or IV haemorrhoids from January to December 2020 were enrolled. The experimental and control groups received the same conventional treatment and care before the haemorrhoidectomy. The experimental group started warm-water sitz bath 6 h after the surgery, and the control group started warm water sitz bath on post-haemorrhoidectomy day 1 as usual. Urinary retention was defined as use of Foley catheter during the hospital stay or remaining urine volume ≧ 300 ml using the bladder scan. A numerical rating scale was used to rate the pain level. Each participant was evaluated 6 times in total until hospital discharge. The data were analysed by descriptive statistics, chi-square test, and independent samples test. Generalized estimating equations and intention to treat were used to identify changes in urinary retention and pain over time and missing data, respectively. There was no significant difference in the degree of change in the number of people with urinary retention between groups. A change in the wound pain index was noted; the study group had a statistically significant lower pain score than the control group (B = −0.81, 95 % CI: −1.44 to −0.18). Early warm water sitz bath was a safe and effective strategy to decrease post-haemorrhoidectomy pain, but not urinary retention. Nurses could provide early warm water sitz bath for post-haemorrhoidectomy patients' comfort. ClinicalTrials.gov ID: NCT04535765

中文翻译：

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早期温水坐浴对痔疮切除术后尿潴留和疼痛的影响：一项随机对照试验


痔疮是一种常见的慢性肛肠疾病，痔疮切除术是晚期（Ⅲ级和Ⅳ级）痔疮的标准治疗方法。温水坐浴通常用于刺激排尿、清洁伤口和减轻疼痛。虽然尿潴留和疼痛通常发生在术后 24 小时内，但在痔疮切除术后 24 小时提供温水坐浴，这可能会错失优化护理质量和效率的机会。探讨痔疮手术当天早期温水坐浴对预防尿潴留、减轻伤口疼痛的效果。这是一项采用置换区组随机化设计的纵向双盲研究。这项研究是在医疗中心的外科病房进行的。该病房平均每月有18名患者接受痔疮手术。共有 64 名参与者（实验组和对照组各 32 名）参加。 （首次招募日期为2020年1月16日。）2020年1月至12月期间因III级或IV级痔疮接受痔切除术的患者入组。实验组和对照组在痔切除术前均接受相同的常规治疗和护理。实验组术后6h开始温水坐浴,对照组于痔疮术后第1天开始温水坐浴如常。尿潴留定义为住院期间使用Foley导尿管或膀胱扫描剩余尿量≥300ml。使用数字评定量表来评定疼痛程度。每个参与者总共接受了 6 次评估，直至出院。通过描述性统计、卡方检验和独立样本检验对数据进行分析。 广义估计方程和治疗意向分别用于识别尿潴留和疼痛随时间的变化和缺失数据。各组之间尿潴留人数的变化程度无显着差异。注意到伤口疼痛指数的变化；研究组的疼痛评分显着低于对照组（B=-0.81，95% CI：-1.44 至 -0.18）。早期温水坐浴是减少痔疮切除术后疼痛的安全有效策略，但不能减少尿潴留。护士可以早期提供温水坐浴，以使痔疮切除术后患者感到舒适。临床试验。政府 ID：NCT04535765