For the integrated multidisciplinary approach to patient care

Return to the Southern Medical Journal

Current User S2 Access Level: -1 ()
CAN NOT ACCESS LEVEL 2
Original Article

Lack of Preoperative Predictors of the Immediate Return of Postoperative Bladder Emptying After Uterosacral Ligament Suspension

Christopher P. Chung, MD, Thomas J. Kuehl, PhD, Kimberly M. Spoonts, Danilo A. Martins, Wilma I. Larsen, MD, Paul M. Yandell, MD,Bobby L. Shull, MD
Volume: 106 Issue: 4 April, 2013

Abstract:

Objectives: To determine whether preoperative postvoid residual volume (PVR), pelvic organ prolapse quantification (POPQ) stage, patient characteristics, or concurrent operations are predictors of immediate postoperative bladder emptying after uterosacral ligament suspension (USLS).


Methods: A review of patients undergoing USLS in 2008 and 2009 was performed. The factors analyzed included patient age, body mass index, parity, preoperative PVR, POPQ stage, concurrent anterior repair, posterior repair, hysterectomy and/or sling procedures, and postoperative voiding trial status.


Results: During the study interval, 151 patients underwent USLS with various combinations of concurrent procedures. The mean preoperative PVR was 90 mL. Seventy-five patients (50%) passed the postoperative voiding trial on postoperative day 1. Patients who passed the postoperative voiding trial and those who failed had similar average preoperative PVR (P = 0.94), similar age (P = 0.14), body mass index (P = 0.45), parity (P = 0.82), and preoperative POPQ stage (P = 0.80). There was no difference (P ≥ 0.14) among concurrent surgical procedures in the proportion of patients who passed the postoperative voiding trial based on univariate analyses.


Conclusions: In our cohort of patients, preoperative PVR, POPQ stage, and other patient characteristics were not predictors of immediate postoperative bladder emptying after USLS. Postoperative voiding function is one of the most unpredictable aspects of pelvic reconstructive surgery.

Article:

This content is limited to qualifying members. Please click on an option below to view in full. Click here to compare all member plans.

Login

Silver/Gold members login for full access. Other members login to view purchase options.

Create a New Account

Create a new complimentary account/login to view purchase options.

Images:

This content is limited to qualifying members. Please click on an option below to view in full. Click here to compare all member plans.

Login

Silver/Gold members login for full access. Other members login to view purchase options.

Create a New Account

Create a new complimentary account/login to view purchase options.

References:

1. Komesu YM, Rogers RG, Kammerer-Doak DN, et al. Clinical predictors of urinary retention after pelvic reconstructive and stress urinary incontinence surgery. J Reprod Med 2007; 52: 611–615.
 
2. Shadle B, Barbaro C, Waxman K, et al. Predictors of postoperative urinary retention. Am Surg 2009; 75: 922–924.
 
3. Shull BL, Bachofen C, Coates KW, et al. A transvaginal approach to repair of apical and other associated sites of pelvic organ prolapse with uterosacral ligaments. Am J Obstet Gynecol 2000; 183: 1365–1373.
 
4. Griffiths DJ, Harrison G, Moore K, et al. Variability of post-void residual urine volume in the elderly.Urol Res 1996; 24: 23–26.
 
5. Sokol AI, Jelovsek JE, Walters MD, et al. Incidence and predictors of prolonged urinary retention after TVT with and without concurrent prolapse surgery. Am J Obstet Gynecol 2005; 192: 1537–1543.
 
6. Heit M, Vogt V, Brubaker L. An alternative statistical approach for predicting prolonged catheterization after Burch colposuspension during reconstructive pelvic surgery. Int Urogynecol J Pelvic Floor Dysfunct 1997; 8: 203–208.
 
7. McLennan MT, Melick CF, Bent AE. Clinical and urodynamic predictors of delayed voiding after fascia lata suburethral sling. Obstet Gynecol 1998; 92: 608–612.
 
8. Nager CW, Brubaker L, Litman HJ, et al. A randomized trial of urodynamic testing before stress-incontinence surgery. N Engl J Med 2012; 366: 1987–1997.

CME:

Portions of this issue may be available for CME credit. Please email education@sma.org for a complete listing of current Southern Medical Journal activities, as well as other SMA educational offerings.

This content is limited to qualifying members. Please click on an option below to view in full. Click here to compare all member plans.

Login

Silver/Gold members login for full access. Other members login to view purchase options.

Create a New Account

Create a new complimentary account/login to view purchase options.

This content is limited to qualifying members. Please click on an option below to view in full. Click here to compare all member plans.

Login

Silver/Gold members login for full access. Other members login to view purchase options.

Create a New Account

Create a new complimentary account/login to view purchase options.

Permissions