Cargando…

Rate of Postoperative Urinary Retention after Anterior Compartment Prolapse Surgery: A Randomized Controlled Trial Comparing Early versus Conventional Transurethral Catheter Removal

Background: Pelvic organ prolapse is a common condition of pelvic floor dysfunction in women, especially in adult vaginally parous and elderly women. Because of its anatomy, the anterior compartment has a significant effect on urinary symptoms. Anterior colporrhaphy and colpocleisis are major anteri...

Descripción completa

Detalles Bibliográficos
Autores principales: Chansriniyom, Nareenun, Saraluck, Apisith, Kijmanawat, Athasit, Wattanayingcharoenchai, Rujira, Aimjirakul, Komkrit, Manonai Bartlett, Jittima, Chinthakanan, Orawee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219305/
https://www.ncbi.nlm.nih.gov/pubmed/37240539
http://dx.doi.org/10.3390/jcm12103436
_version_ 1785048978436390912
author Chansriniyom, Nareenun
Saraluck, Apisith
Kijmanawat, Athasit
Wattanayingcharoenchai, Rujira
Aimjirakul, Komkrit
Manonai Bartlett, Jittima
Chinthakanan, Orawee
author_facet Chansriniyom, Nareenun
Saraluck, Apisith
Kijmanawat, Athasit
Wattanayingcharoenchai, Rujira
Aimjirakul, Komkrit
Manonai Bartlett, Jittima
Chinthakanan, Orawee
author_sort Chansriniyom, Nareenun
collection PubMed
description Background: Pelvic organ prolapse is a common condition of pelvic floor dysfunction in women, especially in adult vaginally parous and elderly women. Because of its anatomy, the anterior compartment has a significant effect on urinary symptoms. Anterior colporrhaphy and colpocleisis are major anterior compartment prolapse-related surgeries. As we know, postoperative urinary retention (POUR) is one of the most common complications following pelvic floor surgery. To prevent this complication, indwelling bladder catheterization is routinely applied. In contrast, to minimize risk of infection and the patient’s discomfort, the catheter should be removed as soon as possible. However, there is a lack of clarity regarding the optimal timing for catheter removal. Therefore, the aim of this trial is to compare the rate of POUR after anterior prolapse surgery between early transurethral catheter removal (24 h postoperatively) and our standard practice (on postoperative day 3). Methods: We conducted a randomized controlled trial among patients undergoing anterior compartment prolapse surgery between 2020 and 2021 at a university hospital. Women were randomized into two groups. After removal, if the second void residual urine volume exceeded 150 mL, POUR was diagnosed, and intermittent catheterization was performed. The primary outcome was the POUR rate. The secondary outcomes included urinary tract infection, asymptomatic bacteriuria, time to ambulation, time to spontaneous voiding, length of hospitalization, and patient satisfaction. Analysis was performed according to the intention to treat principle. The calculated sample size was 68 patients (34 patients in each group) for a 95% confidence interval, 80% power, 5% probability of type I error, and 10% data loss. Discussion: This study demonstrated that early catheter removal was comparable in POUR rate to conventional treatment with shorter hospitalization among patients undergoing anterior compartment prolapse surgery. Additionally, we observed no re-hospitalization owing to POUR. Therefore, early transurethral catheter removal is preferable following anterior compartment prolapse-related surgery.
format Online
Article
Text
id pubmed-10219305
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-102193052023-05-27 Rate of Postoperative Urinary Retention after Anterior Compartment Prolapse Surgery: A Randomized Controlled Trial Comparing Early versus Conventional Transurethral Catheter Removal Chansriniyom, Nareenun Saraluck, Apisith Kijmanawat, Athasit Wattanayingcharoenchai, Rujira Aimjirakul, Komkrit Manonai Bartlett, Jittima Chinthakanan, Orawee J Clin Med Article Background: Pelvic organ prolapse is a common condition of pelvic floor dysfunction in women, especially in adult vaginally parous and elderly women. Because of its anatomy, the anterior compartment has a significant effect on urinary symptoms. Anterior colporrhaphy and colpocleisis are major anterior compartment prolapse-related surgeries. As we know, postoperative urinary retention (POUR) is one of the most common complications following pelvic floor surgery. To prevent this complication, indwelling bladder catheterization is routinely applied. In contrast, to minimize risk of infection and the patient’s discomfort, the catheter should be removed as soon as possible. However, there is a lack of clarity regarding the optimal timing for catheter removal. Therefore, the aim of this trial is to compare the rate of POUR after anterior prolapse surgery between early transurethral catheter removal (24 h postoperatively) and our standard practice (on postoperative day 3). Methods: We conducted a randomized controlled trial among patients undergoing anterior compartment prolapse surgery between 2020 and 2021 at a university hospital. Women were randomized into two groups. After removal, if the second void residual urine volume exceeded 150 mL, POUR was diagnosed, and intermittent catheterization was performed. The primary outcome was the POUR rate. The secondary outcomes included urinary tract infection, asymptomatic bacteriuria, time to ambulation, time to spontaneous voiding, length of hospitalization, and patient satisfaction. Analysis was performed according to the intention to treat principle. The calculated sample size was 68 patients (34 patients in each group) for a 95% confidence interval, 80% power, 5% probability of type I error, and 10% data loss. Discussion: This study demonstrated that early catheter removal was comparable in POUR rate to conventional treatment with shorter hospitalization among patients undergoing anterior compartment prolapse surgery. Additionally, we observed no re-hospitalization owing to POUR. Therefore, early transurethral catheter removal is preferable following anterior compartment prolapse-related surgery. MDPI 2023-05-12 /pmc/articles/PMC10219305/ /pubmed/37240539 http://dx.doi.org/10.3390/jcm12103436 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chansriniyom, Nareenun
Saraluck, Apisith
Kijmanawat, Athasit
Wattanayingcharoenchai, Rujira
Aimjirakul, Komkrit
Manonai Bartlett, Jittima
Chinthakanan, Orawee
Rate of Postoperative Urinary Retention after Anterior Compartment Prolapse Surgery: A Randomized Controlled Trial Comparing Early versus Conventional Transurethral Catheter Removal
title Rate of Postoperative Urinary Retention after Anterior Compartment Prolapse Surgery: A Randomized Controlled Trial Comparing Early versus Conventional Transurethral Catheter Removal
title_full Rate of Postoperative Urinary Retention after Anterior Compartment Prolapse Surgery: A Randomized Controlled Trial Comparing Early versus Conventional Transurethral Catheter Removal
title_fullStr Rate of Postoperative Urinary Retention after Anterior Compartment Prolapse Surgery: A Randomized Controlled Trial Comparing Early versus Conventional Transurethral Catheter Removal
title_full_unstemmed Rate of Postoperative Urinary Retention after Anterior Compartment Prolapse Surgery: A Randomized Controlled Trial Comparing Early versus Conventional Transurethral Catheter Removal
title_short Rate of Postoperative Urinary Retention after Anterior Compartment Prolapse Surgery: A Randomized Controlled Trial Comparing Early versus Conventional Transurethral Catheter Removal
title_sort rate of postoperative urinary retention after anterior compartment prolapse surgery: a randomized controlled trial comparing early versus conventional transurethral catheter removal
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219305/
https://www.ncbi.nlm.nih.gov/pubmed/37240539
http://dx.doi.org/10.3390/jcm12103436
work_keys_str_mv AT chansriniyomnareenun rateofpostoperativeurinaryretentionafteranteriorcompartmentprolapsesurgeryarandomizedcontrolledtrialcomparingearlyversusconventionaltransurethralcatheterremoval
AT saraluckapisith rateofpostoperativeurinaryretentionafteranteriorcompartmentprolapsesurgeryarandomizedcontrolledtrialcomparingearlyversusconventionaltransurethralcatheterremoval
AT kijmanawatathasit rateofpostoperativeurinaryretentionafteranteriorcompartmentprolapsesurgeryarandomizedcontrolledtrialcomparingearlyversusconventionaltransurethralcatheterremoval
AT wattanayingcharoenchairujira rateofpostoperativeurinaryretentionafteranteriorcompartmentprolapsesurgeryarandomizedcontrolledtrialcomparingearlyversusconventionaltransurethralcatheterremoval
AT aimjirakulkomkrit rateofpostoperativeurinaryretentionafteranteriorcompartmentprolapsesurgeryarandomizedcontrolledtrialcomparingearlyversusconventionaltransurethralcatheterremoval
AT manonaibartlettjittima rateofpostoperativeurinaryretentionafteranteriorcompartmentprolapsesurgeryarandomizedcontrolledtrialcomparingearlyversusconventionaltransurethralcatheterremoval
AT chinthakananorawee rateofpostoperativeurinaryretentionafteranteriorcompartmentprolapsesurgeryarandomizedcontrolledtrialcomparingearlyversusconventionaltransurethralcatheterremoval