Subjective versus objective determination of bladder emptying following urogynecological surgery: “do you feel that you completely emptied your bladder?”

Kesty, Kendra; Edenfield, Autumn L.; Castro, Daniela; Medina, Loreto; Naser, Michel; Manrı́quez, V.; Swift, Steven

doi:10.1007/s00192-019-04216-0

Cited by 9 publications

(5 citation statements)

References 11 publications

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“…To identify and manage acute postoperative retention early enough, simple non-invasive techniques might be sufficient. A recent study evaluated if women are able to subjectively determine if they have emptied their bladder after a spontaneous void following urogynecological surgery to rule-out postoperative urinary retention by an objective voiding trial [ 27 ]. The negative predictive value of the subjective question regarding bladder emptying was >97%.…”

Section: Discussionmentioning

confidence: 99%

Wide Variation in Post-Void Residual Management after Urogynecologic Surgery: A Survey of Urogynecologists’ Practices

Marschalek

Umek

Koelbl

et al. 2021

JCM

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To date there is no standardized regimen or evidence-based practical guideline concerning post-void residual (PVR) measurement after urogynecologic surgeries. This survey aimed to evaluate current practice patterns and the approach taken among urogynecologists surrounding PVR measurement. An online survey was sent to members of several urogynecologic societies assessing pre- and postoperative management of patients undergoing urogynecologic surgery. A total of 204 urogynecologists from 21 countries participated in the survey. The vast majority of urogynecologists perform some kind of voiding trial to assess voiding function postoperatively. The cut-off values to perform catheterization, the methods of measurement, and the number of successfully passed voiding showed strong differences. Only 34.4% of the respondents consider routine PVR measurement after urogynecologic surgery to be evidence-based. PVR measurement after urogynecologic surgeries is widely performed and if pathological, it almost always provokes invasive treatment. However, there is a wide variation of implemented strategies, methods, and cut-off values. Scientific societies are challenged to devise a standardized regimen based on evidence for the management of urinary retention after urogynecologic surgery.

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Section: Discussionmentioning

confidence: 99%

Wide Variation in Post-Void Residual Management after Urogynecologic Surgery: A Survey of Urogynecologists’ Practices

Marschalek

Umek

Koelbl

et al. 2021

JCM

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“…Previous studies have also shown that even low-cost routine interventions are responsible for substantial healthcare expenditures [28]. Postoperative urinary retention was similar among those with a strict voiding protocol and those discharged with their subjective determination after gynecologic and urogynecologic surgery [29], with a negative predictive value of 97% [30]. Our results show that the less stringent criteria used in the FOS protocol are safe and effective and do not appear to increase the risk of catheterization and voiding dysfunction after discharge.…”

Section: Discussionmentioning

confidence: 87%

Methods of postoperative void trial management after urogynecologic surgery ： a systematic review and meta-analysis

Dong

Niu

et al. 2022

Preprint

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Background: To systematically review and meta-analyze postoperative void trials (VTs) following urogynecologic surgery to investigate (1) the optimal postoperative VT methodology and (2) the optimal criteria for assessing VT. Method: We searched the PubMed, EMBASE, Cochrane Library, Ovid Medline, and relevant reference lists of eligible articles up to April 2022. This review included randomized controlled trials (RCTs). Relative risks (RRs) and weighted mean differences (WMDs), each with 95% confidence intervals (CIs) were also calculated. The risk of bias was assessed using the Cochrane Risk of Bias tool. Results: VT methodology included backfill-assisted and autofill studies (two RCTs, n=95). Backfill assistance was more likely to be successful than autofill (RR 2.12, 95% CI 1.29, 3.47, P = .00); however, no significant difference was found in the time to discharge (WMDs= –29.11 min, 95% CI -57.45, 1.23, P = .06). Criteria for passing VT included subjective assessment of the urinary force of stream (FOS) and objective assessment of the standard voiding trial (SVT) (3 RCTs, n=377). No significant differences were found in the correct passing rate (RR 0.97, 95% CI 0.93, 1.01, P = .14) or VT failure rate (RR 0.78, 95% CI 0.52,1.18, P = .24). Moreover, no significant differences were found in the complication rates orpatient satisfaction between the two criteria. Conclusion: Bladder backfilling was associated with a lower rate of catheter discharge after urogynecologic surgery. The subjective assessment of FOS is a reliable and safe method for assessing postoperative voiding because it is less invasive. Systematic review registration: PROSPERO CRD42022313397.

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“…When Willis-Gray et al 14 compared the RF VT with and without a PVR criterion after pelvic reconstructive surgery, they found a similar VT failure rate (53% for both groups) and VD rates (4 vs 5%, respectively) between the groups. Importantly, Kesty et al 15 showed that the negative predictive value of patients’ positive responses to the question, “Do you feel that you completely emptied your bladder?” was 97% for return to normal voiding, suggesting that it may be reasonable to use this question in place of a formal VT. Notably, in all these recent attempts to simplify postoperative voiding assessment, retrograde bladder fill has remained an integral part of VTs.…”

Section: Discussionmentioning

confidence: 99%

“…We designed a questionnaire (Fig. 1) by adapting several key components and principles from the “Overactive Bladder Satisfaction of Treatment Questionnaire”: treatment satisfaction, adverse psychological effects, endorsement, and convenience 15 . After the VT, and before discharge, patients were asked to respond to one question for each component by marking their subjective experience with the VT on a visual analog scale (0–100 mm).…”

Section: Design and Methodologymentioning

confidence: 99%

Voided Volume for Assessment of Bladder Emptying After Female Pelvic Floor Surgery: A Randomized Controlled Trial

Popiel

Getaneh²,

Yeh³

et al. 2022

UROGC

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Importance To study alternative voiding trial (VT) methods after urogynecologic surgery that may potentially decrease catheterization. Objective The aim of the study is to compare voiding assessment based on a minimum spontaneous voided volume of 150 mL with the standard retrograde fill (RF) approach in women after urogynecologic procedures. Study Design Women undergoing urogynecologic surgery were randomized to RF or spontaneous void (SV) groups. Women in the RF group had their bladders backfilled with 300 mL of saline before catheter removal, those in the SV group did not. To pass the VT, patients in the RF group were required to void 150 mL at one time within 60 minutes, and patients in the SV group had to do the same within 6 hours. The primary outcome was the VT failure rate. We also compared the false pass rate, urinary tract infections, satisfaction, and preference of VT method. Results One hundred nine women were enrolled in the study, 54 had SV and 55 underwent RF. Baseline characteristics were not significantly different other than history of prior hysterectomy. There was no significant difference in procedures between the groups. There was no difference in VT failure rate between the groups—SV (7.4%) and RF (12.7%, P = 0.39). The false pass rate was 0 in each group. Urinary tract infection rates were similar between SV (14.8%) and RF (14.5%) groups (P = 0.34). Patient satisfaction for VT method was not significantly different. Conclusions Spontaneous VT was not superior to retrograde void trial. Therefore, we cannot recommend one method of VT after urogynecologic surgery. Condensation Voiding assessment based on minimum SV of 150 mL is comparable with VT with RF after surgeries for prolapse and urinary incontinence.

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Subjective versus objective determination of bladder emptying following urogynecological surgery: “do you feel that you completely emptied your bladder?”

Cited by 9 publications

References 11 publications

Wide Variation in Post-Void Residual Management after Urogynecologic Surgery: A Survey of Urogynecologists’ Practices

Wide Variation in Post-Void Residual Management after Urogynecologic Surgery: A Survey of Urogynecologists’ Practices

Methods of postoperative void trial management after urogynecologic surgery ： a systematic review and meta-analysis

Voided Volume for Assessment of Bladder Emptying After Female Pelvic Floor Surgery: A Randomized Controlled Trial

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