Abstract:Objective To evaluate the effect of bladder training by clamping prior to removal urinary catheters on the incidences of complications associated with short-term indwelling urinary catheters. Methods A computerized search in PubMed, Cochrane Library, Medline, Embase, CINAHL, Scopus, China National Knowledge Infrastructure (CNKI) and Wan Fang Data were performed to retrieve randomized controlled trials (RCTs) on bladder training by clamping versus free drainage prior to removal of urinary catheters for patients with short-term indwelling urinary catheters. Meta-analysis of the trials was conducted using RevMan 5.3.5 software. Results A total of 20 studies were included, adding up to 3 899 patients.Compared to the free drainage group, the risks of urinary retention after catheter removal [RR=0.33,95%CI(0.16,0.70),P<0.01]], urinary catheter reinsertion[RR=0.50,95%CI(0.38,0.67),P<0.01], voiding dysfunction [RR=0.31,95%CI(0.14,0.71),P<0.01], and patient perceived voiding-related discomfort [RR=0.56,95%CI(0.36,0.86),P<0.01] were significantly lower in the clamping group. The risk of catheter-associated urinary tract infections (CAUTI) in the clamping group was 1.11 times that of the free drainage group [RR=1.11,95%CI(0.71,1.74)], without statistical significance (P>0.05). Conclusion Bladder training by clamping could lower the post-catheter-removal risks of urinary retention, urinary catheter reinsertion, and voiding dysfunction, though evidence on the increased risk of urinary tract infection by clamping is limited.It is recommended that catheters be removed as soon as possible if the patient is indicated for removal. The current evidence cannot rule out that bladder training by clamping is meaningless. Large sample, multi-centered trials, and objective outcome measures are still needed to evaluate the role of bladder training by clamping.