Bladder Dysfunction after Gynecologic Laparoscopic Surgery for Benign Disease

Won, H.; Maley, P.; Chetty, Naven; Chan, Karen Kar Loen; Abbott, Jason

doi:10.1016/j.jmig.2011.09.013

Cited by 19 publications

(23 citation statements)

References 24 publications

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“…For instance, it might be too late to discharge patients on the same‐day if they can only void between 6 and 9 hours after surgery. A study demonstrated that it was difficult to predict preoperatively who is at risk of voiding dysfunction . Although our study was not designed to study the risk factors associated with urinary retention, we observed that women who were confronted with voiding difficulties had significantly more intra‐operative blood loss.…”

Section: Discussionmentioning

confidence: 81%

“…A study demonstrated that it was difficult to predict preoperatively who is at risk of voiding dysfunction. 18 Although our study was not designed to study the risk factors associated with urinary retention, we observed that women who were confronted with voiding difficulties had significantly more intra-operative blood loss. Numbers did not allow us to determine a cut-off.…”

Section: Discussionmentioning

confidence: 85%

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Immediate versus delayed removal of urinary catheter after laparoscopic hysterectomy: a randomised controlled trial

Sandberg

Twijnstra

Meir

et al. 2019

BJOG

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Objective To evaluate if immediate catheter removal ( ICR ) after laparoscopic hysterectomy is associated with similar retention outcomes compared with delayed removal ( DCR ). Study design Non‐inferiority randomised controlled trial. Population Women undergoing laparoscopic hysterectomy in six hospitals in the Netherlands. Methods Women were randomised to ICR or DCR (between 18 and 24 hours after surgery). Primary outcome The inability to void within 6 hours after catheter removal. Results One hundred and fifty‐five women were randomised to ICR ( n = 74) and DCR ( n = 81). The intention‐to‐treat and per‐protocol analysis could not demonstrate the non‐inferiority of ICR : ten women with ICR could not urinate spontaneously within 6 hours compared with none in the delayed group (risk difference 13.5%, 5.6–24.8, P = 0.88). However, seven of these women could void spontaneously within 9 hours without additional intervention. Regarding the secondary outcomes, eight women from the delayed group requested earlier catheter removal because of complaints (9.9%). Three women with ICR (4.1%) had a urinary tract infection postoperatively versus eight with DCR (9.9%, risk difference −5.8%, −15.1 to 3.5, P = 0.215). Women with ICR mobilised significantly earlier (5.7 hours, 0.8–23.3 versus 21.0 hours, 1.4–29.9; P ≤ 0.001). Conclusion The non‐inferiority of ICR could not be demonstrated in terms of urinary retention 6 hours after procedure. However, 70% of the women with voiding difficulties could void spontaneously within 9 hours after laparoscopic hysterectomy. It is therefore questionable if all observed urinary retention cases were clinically relevant. As a result, the clinical advantages of ICR may still outweigh the risk of bladder retention and it should therefore be considered after uncomplicated laparoscopic hysterectomy. Tweetable abstract The advantages of immediate catheter removal after laparoscopic hysterectomy seem to outweigh the risk of bladder retention.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 85%

Immediate versus delayed removal of urinary catheter after laparoscopic hysterectomy: a randomised controlled trial

Sandberg

Twijnstra

Meir

et al. 2019

BJOG

View full text Add to dashboard Cite

show abstract

“…Our previous prospective observational study demo‐nstrated that 20% of women having laparoscopy for benign, non‐hysterectomy indications had post‐operative urinary retention. Those women who received icodextrin were significantly more likely to encounter this dysfunction, although the numbers in this group were small . Based upon the results of that study, we estimated that up to 50% of women with icodextrin may have urinary retention.…”

Section: Methodsmentioning

confidence: 93%

“…Data from an earlier study conducted in our unit found that post‐operative urinary retention occurred in 20/102 (19.6%) women undergoing laparoscopic gynaecological surgery for benign pathology. The use of icodextrin anti‐adhesion solution was the only factor associated with a significantly higher incidence of urinary retention, occurring in 4/17 (23.5%) women who received icodextrin versus 16/85 (18.8%) women who did not receive icodextrin ( P < 0.001) …”

Section: Introductionmentioning

confidence: 98%

“…Urinary retention is a significant post‐operative comp‐lication, with a reported incidence following laparoscopic surgery of between 1.2 and 22.9% . It is defined as the inability to void with a full bladder in the post‐operative period despite persistent effort and may be associated with bladder distension, pain, agitation and extended hospital stay .…”

Section: Introductionmentioning

confidence: 99%

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