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Postoperative urinary retention after pelvic organ prolapse surgery: influence of peri-operative factors and trial of void protocol
PURPOSE: Transient postoperative urinary retention (POUR) is common after pelvic floor surgery. We aimed to determine the association between peri-operative variables and POUR and to determine the number of voids required for post-void residuals (PVRs) to normalize postoperatively. METHODS: We condu...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111911/ https://www.ncbi.nlm.nih.gov/pubmed/33975584 http://dx.doi.org/10.1186/s12905-021-01330-4 |
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author | Anglim, B. C. Ramage, K. Sandwith, E. Brennand, E. A. |
author_facet | Anglim, B. C. Ramage, K. Sandwith, E. Brennand, E. A. |
author_sort | Anglim, B. C. |
collection | PubMed |
description | PURPOSE: Transient postoperative urinary retention (POUR) is common after pelvic floor surgery. We aimed to determine the association between peri-operative variables and POUR and to determine the number of voids required for post-void residuals (PVRs) to normalize postoperatively. METHODS: We conducted a retrospective cohort study of 992 patients undergoing pelvic floor surgery at a tertiary referral centre from January 2015 to October 2017. Variables assessed included: age, BMI, ASA score, anaesthesia type, type of surgery, length of postoperative stay, surgeon, bladder protocol used, and number of PVRs required to “pass” the protocol. RESULTS: Significant risk factors for POUR included: placement of MUS during POP surgery, anterior repair and hysterectomy with concomitant sacrospinous vault suspension. A total of 25.1% were discharged requiring catheterization. Patients receiving a concomitant mid-urethral sling (MUS) were 2.2 (95% CI1.6–2.9) and 2.3 (95% CI 1.8–3.1) times more likely to have elevated PVR after their second TOV and third TOV (p < 0.0001), respectively, compared with those without concomitant MUS. Permitting a third TOV allowed an additional 10% of women to pass the voiding protocol before discharge. The median number of voids to pass protocol was 2. An ASA > 2 and placement of MUS were associated with increasing number of voids needed to pass protocol. CONCLUSIONS: While many women passed protocol by the second void, using the 3rd void as a cut point to determine success would result in fewer women requiring catheterization after discharge. Prior to pelvic floor surgery, women should be counselled regarding POUR probability to allow for management of postoperative expectations. |
format | Online Article Text |
id | pubmed-8111911 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-81119112021-05-11 Postoperative urinary retention after pelvic organ prolapse surgery: influence of peri-operative factors and trial of void protocol Anglim, B. C. Ramage, K. Sandwith, E. Brennand, E. A. BMC Womens Health Research PURPOSE: Transient postoperative urinary retention (POUR) is common after pelvic floor surgery. We aimed to determine the association between peri-operative variables and POUR and to determine the number of voids required for post-void residuals (PVRs) to normalize postoperatively. METHODS: We conducted a retrospective cohort study of 992 patients undergoing pelvic floor surgery at a tertiary referral centre from January 2015 to October 2017. Variables assessed included: age, BMI, ASA score, anaesthesia type, type of surgery, length of postoperative stay, surgeon, bladder protocol used, and number of PVRs required to “pass” the protocol. RESULTS: Significant risk factors for POUR included: placement of MUS during POP surgery, anterior repair and hysterectomy with concomitant sacrospinous vault suspension. A total of 25.1% were discharged requiring catheterization. Patients receiving a concomitant mid-urethral sling (MUS) were 2.2 (95% CI1.6–2.9) and 2.3 (95% CI 1.8–3.1) times more likely to have elevated PVR after their second TOV and third TOV (p < 0.0001), respectively, compared with those without concomitant MUS. Permitting a third TOV allowed an additional 10% of women to pass the voiding protocol before discharge. The median number of voids to pass protocol was 2. An ASA > 2 and placement of MUS were associated with increasing number of voids needed to pass protocol. CONCLUSIONS: While many women passed protocol by the second void, using the 3rd void as a cut point to determine success would result in fewer women requiring catheterization after discharge. Prior to pelvic floor surgery, women should be counselled regarding POUR probability to allow for management of postoperative expectations. BioMed Central 2021-05-11 /pmc/articles/PMC8111911/ /pubmed/33975584 http://dx.doi.org/10.1186/s12905-021-01330-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Anglim, B. C. Ramage, K. Sandwith, E. Brennand, E. A. Postoperative urinary retention after pelvic organ prolapse surgery: influence of peri-operative factors and trial of void protocol |
title | Postoperative urinary retention after pelvic organ prolapse surgery: influence of peri-operative factors and trial of void protocol |
title_full | Postoperative urinary retention after pelvic organ prolapse surgery: influence of peri-operative factors and trial of void protocol |
title_fullStr | Postoperative urinary retention after pelvic organ prolapse surgery: influence of peri-operative factors and trial of void protocol |
title_full_unstemmed | Postoperative urinary retention after pelvic organ prolapse surgery: influence of peri-operative factors and trial of void protocol |
title_short | Postoperative urinary retention after pelvic organ prolapse surgery: influence of peri-operative factors and trial of void protocol |
title_sort | postoperative urinary retention after pelvic organ prolapse surgery: influence of peri-operative factors and trial of void protocol |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111911/ https://www.ncbi.nlm.nih.gov/pubmed/33975584 http://dx.doi.org/10.1186/s12905-021-01330-4 |
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