Objectives
This study aimed to compare a backfill-assisted voiding trial (VT) with and without a postvoid residual (PVR) after pelvic reconstructive surgery.
Methods
This was a nonblinded randomized controlled trial of women undergoing pelvic organ prolapse and/or stress incontinence surgery. Participants were randomized immediately after surgery to either a PVR VT or a PVR-free VT. Our primary outcome was the rate of VT failure at discharge. Secondary outcomes included days of catheterization, urinary tract infection (UTI), and prolonged voiding dysfunction. With a power of 80% and an α of 0.05, we needed 126 participants to detect a 25% difference in VT failure (60% in PVR VT vs 35% in PVR-free VT).
Results
Participants were enrolled from March 2017 to October 2017. Of the 150 participants, mean age was 59 years, and 33% underwent vaginal hysterectomy, 48% underwent anterior repair, and 75% underwent midurethral sling. Seventy-five (50%) were randomized to PVR VT and 75 (50%) to PVR-free VT, with no differences in baseline demographic or intraoperative characteristics between the 2 groups. Our primary outcome, VT failure, was not significantly different (53% PVR VT vs 53% PVR-free VT, P = 1.0). There were no significant differences in days of postoperative catheterization (1 [0, 4] in PVR VT vs 1 [0, 4] in PVR-free VT, P = 0.90), UTI (20% PVR VT vs 20% PVR-free VT, P = 1.0), or postoperative voiding dysfunction (4% PVR VT vs 5% PVR-free VT, P = 1.0).
Conclusions
When performing a backfill-assisted VT, checking a PVR does not affect VT failure, postoperative duration of catheterization, UTI, or voiding dysfunction.
Purpose-The objective is to estimate the prevalence of symptoms suggestive of Painful Bladder Syndrome (PBS) defined as pain increasing as the bladder fills and/or pain relieved by urination for at least three months and its association with socio-demographics (gender, age, race/ethnicity, and socioeconomic status), lifestyle (smoking, alcohol consumption, physical activity) and psychosocial variables (sexual, physical, emotional abuse experienced as a child or as an adult, worry, trouble paying for basics, depression).Materials and Methods-The data used come from the Boston Area Community Health (BACH) survey, an epidemiologic study of 5506 randomly selected adults aged 30-79 of three race/ethnic groups (Black, Hispanic, White).Results-The overall prevalence of symptoms suggestive of PBS is two percent (1.3% in men and 2.6% in women) with increased prevalence in middle aged adults and those of lower socioeconomic status. Symptoms suggestive of PBS are more common in those who have experienced abuse, in those who are worried about someone close to them, and in those who are having trouble paying for basics. This pattern holds even after adjusting for depression.Conclusions-PBS is associated with a number of lifestyle and psychosocial correlates. This suggests that the management of patients with PBS (physical symptoms) may benefit from a multifaceted approach of combining medical and psychological, and cognitive treatment.
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