Predictors of Acute Postoperative Urinary Retention after Transvaginal Uterosacral Suspension Surgery

Son, Eun-Joo; Joo, Eunwook; Hwang, Woo Yeon; Kang, Myung‐Hee; Choi, Hyun Jin; Yoo, Eun Hee

doi:10.6118/jmm.2018.24.3.163

Cited by 6 publications

(11 citation statements)

References 19 publications

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“…While elevated preoperative PVR tends to resolve after pelvic organ prolapse surgery in the long term, 14 its impact on immediate POUR has been controversial. Two studies demonstrating that elevated preoperative PVR was associated with acute POUR were limited to uterosacral suspensions 15 and transobturator tape procedures 16 . Another study only included women who underwent pelvic floor repair without concurrent incontinence procedures 17 while one recent study excluded patients with preoperative PVR more than 150 ml 18 .…”

Section: Discussionmentioning

confidence: 99%

“…13 While elevated preoperative PVR tends to resolve after pelvic organ prolapse surgery in the long term, 14 its impact on immediate POUR has been controversial. Two studies demonstrating that elevated preoperative PVR was associated with acute POUR were limited to uterosacral suspensions 15 and transobturator tape procedures. 16 Another study Note: In particular, score of 2 (n = 6) and 3 (n = 62) were combined, as well as, for score of 9 (n = 13), 10 (n = 8) and 11 (n = 5).…”

Section: Discussionmentioning

confidence: 99%

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Risk factors for urinary retention after urogynecologic surgery: A retrospective cohort study and prediction model

Zhang

Wong

Koenig

et al. 2021

Neurourology and Urodynamics

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Aims Postoperative urinary retention (POUR) is a common complication of urogynecological surgery. Our study aimed to identify demographic and perioperative risk factors to construct a prediction model for POUR in urogynecology. Methods Our retrospective cohort study reviewed all patients undergoing pelvic reconstructive surgeries at our tertiary care center (Jan 1, 2013–May 1, 2019). Demographic, pre‐, intra‐ and postoperative variables were collected from medical records. The primary outcome, POUR, was defined as (1) early POUR (E‐POUR), failing initial trial of void or; (2) late POUR (L‐POUR), requiring an indwelling catheter or intermittent catheterization on discharge. Risk factors were identified through univariate and multivariate logistic regression analyses. A clinical prediction model was constructed with the most significant and clinically relevant risk factors. Results In 501 women, 182 (36.3%) had E‐POUR and 61 of these women (12.2% of the entire cohort) had L‐POUR. Multivariate logistic regression revealed preoperative postvoid residual (PVR) over 200 ml (odds ratio [OR]: 3.17; p = 0.026), voiding dysfunction symptoms extracted from validated questionnaires (OR: 3.00; p = 0.030), and number of concomitant procedures (OR: 1.30 per procedure; p = 0.021) as significant predictors of E‐POUR; preoperative PVR more than 200 ml (OR: 4.07; p = 0.011) and antiincontinence procedure with (OR: 3.34; p = 0.023) and without (OR: 2.64; p = 0.019) concomitant prolapse repair as significant predictors of L‐POUR. A prediction model (area under the curve: 0.70) was developed for E‐POUR. Conclusions Elevated preoperative PVR is the most significant risk factor for POUR. Alongside other risk factors, our prediction model for POUR can be used for patient counseling and surgical planning in urogynecologic surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk factors for urinary retention after urogynecologic surgery: A retrospective cohort study and prediction model

Zhang

Wong

Koenig

et al. 2021

Neurourology and Urodynamics

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“…High PVRs can be caused by bladder outlet obstruction (BOO) or bladder underactivity [26] . Son EJ et al [27] discovered a connection between PVR and POUR and suggested that PVR over 30% of total bladder capacity should be considered a predictor of POUR following vaginal reconstructive surgery. Lo TS et al [22] proposed that PVR greater than 200ml is an independent risk factor of the development of POUR.…”

Section: Discussionmentioning

confidence: 99%

“…Higher PVR generally indicates increased outlet resistance, decreased bladder contractility and storage disorders or disorders of emptying [27] .…”

Section: Discussionmentioning

confidence: 99%

Predictors of postoperative urinary retention after severe pelvic organ prolapse

Zhang

Xia

2023

Preprint

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Objective: To investigate the rate of postoperative urinary retention (POUR) and to identify factors associated with POUR of severe pelvic organ prolapse (POP). Methods: A retrospective chart review was conducted for 194 patients who were diagnosed with severe POP. Among them, 152 patients underwent total pelvic floor reconstruction and 42 patients underwent traditional vaginal hysterectomy and vaginal wall repair. POUR was defined as a need for the post-void residual urine volume was＞150mL who should be catheterization subsequent to the removal of the indwelling urethral catheter. Results: POUR was reported in 51 women (26.3%). The incidence of POUR was 28.3% of patients who underwent the total pelvic floor reconstruction. And was 19.0% after traditional vaginal hysterectomy and vaginal wall repair. Crude analysis revealed a significant association between the following variables and the risk of POUR: Aa, Ba, C by POP-Q exam, POP-Q staging, diabetes mellitus, Preoperative post-void residual volume (PVR) , bladder neck mobility, preoperative incontinence (P < 0.05) . POP-Q Staging (odds ratio, 4.79; 95% confidence interval, 1.025-22.383; P=0.046), PVR (odds ratio,1.054; 95% confidence interval, 1.03-1.079; P＜0.01), bladder neck mobility (odds ratio, 1.078; 95% confidence interval,1.021-1.138; P = 0.007) and complaint of incontinence (odds ratio, 2.686; 95% confidence interval,1.101-6.553; P = 0.03) were identified as the significant predictor of POUR In the logistic regression analysis. Conclusion: POP-Q staging, Preoperative post-void residual volume (PVR), bladder neck mobility and complaint of incontinence were significant predictors for POUR after severe pelvic organ prolapse surgery.

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“…Porous synthetic tapes (sling) have been globally used in such surgeries [8]; although this procedure has a high cure rate for SUI after 12 months, severe complications as erosion has been associated with the poor biocompatibility and inadequate biomechanical properties of polypropylene mesh-as lack of elasticity and high stiffness-when it is implanted into the pelvic floor [9,10]. Urinary retention has been a common postoperative complication [11,12]. If urinary retention persists, it can damage surgical repair and cause urinary tract infection.…”

Section: Introductionmentioning

confidence: 99%

Biocompatible Elastomer with Adjustable Mechanical Properties and Degradation Rate as a Midline Segment of Bipartite Sling

Oliveira¹,

Branciforti²

2021

Pharmacophore

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Surgeries for suspending the urethra with synthetic porous tapes (sling) use are effective for curing stress urinary incontinence (SUI). The shortening of the urethral canal and urinary retention are recurrent postoperative problems caused by the tension exerted by the sling on the urethra. This study evaluated the behavior of a biocompatible, bioresorbable, and biodegradable poly (glycerol sebacate) (PGS) elastomer applied as a middle connection of the bipartite sling, which, when degraded, relieves the tension on the organ. Bipartite slings (BS) were fabricated with PGS as a median portion to interconnect their parts. PGS elastomers were synthesized in the common microwave, cured at different curing times in a vacuum oven, and evaluated regarding adhesion strength and mechanical properties by tensile test after in vitro degradation. Bothprepolymer (pre-PGS) and PGS elastomers (E) were assessed by Fourier transform infrared spectroscopy (FTIR) and nuclear magnetic resonance (NMR). The analyses revealed a higher degree of esterification (DE) and crosslinking for samples prepared by curing for 72 h, as well as better performance of mechanical properties over 45 days of in vitro degradation incubation. PGS elastomer prepared at 48 to 72 h curing times has proven suitable as a median portion of the bipartite slings used in surgeries for suspending the urethra in the SUI treatment.

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Predictors of Acute Postoperative Urinary Retention after Transvaginal Uterosacral Suspension Surgery

Cited by 6 publications

References 19 publications

Risk factors for urinary retention after urogynecologic surgery: A retrospective cohort study and prediction model

Risk factors for urinary retention after urogynecologic surgery: A retrospective cohort study and prediction model

Predictors of postoperative urinary retention after severe pelvic organ prolapse

Biocompatible Elastomer with Adjustable Mechanical Properties and Degradation Rate as a Midline Segment of Bipartite Sling

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