Impact of Retained Cystoscopy Fluid after Laparoscopic Hysterectomy: A Randomized Controlled Trial

Smith, Richard F.; Mahnert, Nichole; Hu, Chengcheng; Steck-Bayat, K.P.; Womack, A.S.; Mourad, J.

doi:10.1016/j.jmig.2020.05.024

Cited by 4 publications

(11 citation statements)

References 19 publications

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“…After exclusion of duplicate or irrelevant references, 15 full-text articles were assessed for eligibility. After a detailed evaluation of these articles, only 5 RCTs [8,[13][14][15][16] comprising 488 patients were included in the quantitative synthesis of this systematic review (Supplementary Fig. 1).…”

Section: Search Strategymentioning

confidence: 99%

Bladder Backfilling versus Standard Catheter Removal for Trial of Void after Outpatient Laparoscopic Gynecologic Surgery: A Systematic Review and Meta-Analysis

Dong

Pan

Wang

et al. 2022

Journal of Minimally Invasive Gynecology

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Section: Search Strategymentioning

confidence: 99%

Bladder Backfilling versus Standard Catheter Removal for Trial of Void after Outpatient Laparoscopic Gynecologic Surgery: A Systematic Review and Meta-Analysis

Dong

Pan

Wang

et al. 2022

Journal of Minimally Invasive Gynecology

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“…Three studies reported patient satisfaction using a Likert scale. 7,8,10 There was no difference between the intervention and control groups in the proportion of patients reporting being satisfied or very satisfied with the intervention (RR 0.95; 95% CI 0.82 to 1.10, three studies, 234 patients, P =.48, I 2 =37%, random effects model). Three studies reported unanticipated postoperative medical visits with variable follow-up durations (1 week, 2 weeks, and up to 8 weeks).…”

Section: Resultsmentioning

confidence: 99%

“…Int J Gynecol Obstet 2018;143:334-5.). [5][6][7][8][9][10] In keeping with the growing trend of enhanced recovery, a systematic evaluation of the potential benefits of bladder retrofilling would help provide guidance about whether it should be incorporated into discharge protocols. Decreasing the amount of time required in the hospital after surgery would significantly affect valuable health care resources and the patient's risk of exposure from being in a health care facility.…”

Section: Tabulation Integration and Resultsmentioning

confidence: 99%

“…Five studies (n5576) evaluated retrofilling the bladder after minimally invasive hysterectomy for benign or malignant, nonurogynecologic indications (Davis et al Gynecol Oncol 2018;149:41.). [6][7][8][9] Three studies (n5597) included heterogeneous patient populations undergoing outpatient gynecologic surgeries. Five trials retrofilled the bladder in the operating room after surgery and blinded the patient and outcome assessors to group assignment (Benjamin and Bhagavath.…”

Section: Resultsmentioning

confidence: 99%

“…Int J Gynecol Obstet 2018;143:334-5). 6,7,9,10 The remaining three trials retrofilled the bladder in the postanesthesia care unit and were unblinded (Davis et al Gynecol Oncol 2018;149:41.). 5,8 All of the included studies used a parallel design.…”

Section: Resultsmentioning

confidence: 99%

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Retrograde Bladder Filling After Outpatient Gynecologic Surgery

Thiel

Mathur

Zakhari

et al. 2021

Obstetrics &Amp; Gynecology

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OBJECTIVE: To systematically review and meta-analyze randomized controlled trials (RCTs) comparing postoperative bladder retrofilling to passive filling after outpatient gynecologic surgery to evaluate effects on postoperative outcomes. DATA SOURCES: We searched MEDLINE, PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, and ClinicalTrials.gov from 1947 to August 2020. METHODS OF STUDY SELECTION: Two reviewers screened 1,465 articles. We included RCTs that compared postoperative bladder retrofilling to passive filling in patients who underwent outpatient gynecologic surgery by any approach. The primary outcome was the time to first void. Secondary outcomes included time to discharge, postoperative urinary retention, urinary tract infection, and patient satisfaction. Mean differences and relative risks (RRs) were calculated for the meta-analysis. Risk of bias was assessed using the Cochrane Risk of Bias Tool. TABULATION, INTEGRATION, AND RESULTS: We included eight studies with 1,173 patients. Bladder retrofilling in the operating room resulted in a significant decrease in the time to first void (mean difference −33.5 minutes; 95% CI −49.1 to −17.9, 4 studies, 403 patients) and time to discharge (mean difference –32.0 minutes; 95% CI −51.5 to −12.6, eight studies, 1,164 patients). Bladder retrofilling did not shorten time to discharge when performed in the postanesthetic care unit (mean difference –14.8 min; 95% CI −62.6 to 32.9, three studies, 258 patients) or after laparoscopic hysterectomy (mean difference –26.0 min; 95% CI −56.5 to 4.5, five studies, 657 patients). There were no differences in postoperative urinary retention (RR 0.77; 95% CI 0.45–1.30, five studies, 910 patients) or risk of urinary tract infection between the retrofill and passive fill groups (RR 0.50; 95% CI 0.14–1.77, four studies, 387 patients). Patient satisfaction was comparable between groups. CONCLUSION: Retrofilling the bladder in the operating room after outpatient gynecologic surgery modestly reduces the time to first void and discharge with no increase in adverse events. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42020203692.

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Active versus Passive Voiding Protocols after Same-day Minimally Invasive Hysterectomy

Ishino

Tucker

Navarrete

et al. 2022

Journal of Minimally Invasive Gynecology

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To determine the proportion of patients discharged with a urinary catheter after a same-day benign gynecologic minimally invasive hysterectomy (MIH) according to active vs passive voiding protocols. The secondary objectives included assessing postanesthesia care unit (PACU) duration and postoperative urinary retention (POUR) rate ≤2 weeks of discharge. Design: Retrospective, observational cohort study. Setting: Large integrated healthcare system serving approximately 40% of the Northern California population. Patients: Patients aged 18 years or older undergoing same-day MIH without urogynecology procedures from 2015 to 2018 were categorized into active or passive voiding trial groups. Active voiding trials were defined as patients arriving in the PACU with a catheter, retrograde filling of the bladder with 300 mL saline then allowing for voiding ≥50% within 30 minutes. If the patients were unable to void this volume, they were discharged with a catheter to be removed within 24 hours. A passive voiding trial involved filling or not filling the bladder before PACU arrival without a catheter, then allowing for voiding or performing a straight catheterization if the patients were unable to void. Interventions: Retrospective cohort study. Measurements and Main Results: A total of 1644 (83.2%) patients underwent passive voiding trials, and 333 (16.8%) underwent active voiding trials. The proportion of patients discharged with a catheter was lower in the passive voiding group than in the active voiding group (5.4% vs 10.5%; p = .001). The passive group had a shorter mean PACU time than the active group (218 § 86 vs 240 § 93 minutes; p <.001). The crude POUR rates for the passive and active voiding groups were 1.8% and 3.0%, respectively (p = .16). Conclusion: Within an integrated healthcare system, patients who underwent passive voiding trials compared with those who underwent active voiding trials were discharged home from the PACU after a shorter duration. In addition, a larger proportion of the patients who underwent passive voiding trials were discharged home without a urinary catheter. There were no differences in the POUR rates. Our findings suggest that passive voiding trials can be safely used after a benign MIH to reduce hospital duration, optimize healthcare resources, and improve patient experience.

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Impact of Retained Cystoscopy Fluid after Laparoscopic Hysterectomy: A Randomized Controlled Trial

Cited by 4 publications

References 19 publications

Bladder Backfilling versus Standard Catheter Removal for Trial of Void after Outpatient Laparoscopic Gynecologic Surgery: A Systematic Review and Meta-Analysis

Bladder Backfilling versus Standard Catheter Removal for Trial of Void after Outpatient Laparoscopic Gynecologic Surgery: A Systematic Review and Meta-Analysis

Retrograde Bladder Filling After Outpatient Gynecologic Surgery

Active versus Passive Voiding Protocols after Same-day Minimally Invasive Hysterectomy

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