Post-Operative Urinary Retention Rates after Autofill versus Backfill Void Trial Following Total Laparoscopic Hysterectomy: A Randomized Controlled Trial (original) (raw)
Related papers
Journal of Minimally Invasive Gynecology, 2007
We sought to evaluate the incidence of postoperative voiding dysfunction in patients undergoing vaginal hysterectomy (VH) or total laparoscopic hysterectomy (TLH) and to identify risk factors for the development of postoperative urinary retention after uncomplicated total hysterectomy. DESIGN: Prospective cohort study (Canadian Task Force classification II-2). SETTING: Gynecology department of a university hospital. PATIENTS: Two hundred thirty-three consecutive women undergoing TLH or VH for benign gynecologic disease. INTERVENTIONS: A regimen of immediate catheter removal after the operation was instituted. A strict voiding trial protocol was used during the study period. Postoperative voiding dysfunction was defined as failure of first voiding trial after surgery (urinary retention) or postvoid residual volume of greater than 150 mL necessitating recatheterization. MEASUREMENTS AND MAIN RESULTS: A total of 49 women (21%) developed postoperative voiding dysfunction, of which 32 (13.7%) had complete urinary retention and 17 (7.3%) had a postvoid residual volume greater than 150 mL. None of these patients experienced voiding dysfunction beyond 48 hours. There was no statistical correlation between development of postoperative voiding dysfunction and demographic, historic, preoperative, and postoperative variables collected. The only factor with significant impact on postoperative voiding dysfunction was vaginal approach to hysterectomy (OR 2.8; 95% CI 1.5-5.4). Hospital stay was significantly longer for women experiencing voiding difficulties than for those who voided efficiently (2.2 Ϯ 0.8 [95% CI 1.5-1.9] vs 1.7 Ϯ 1.2 [95% CI 1.9-2.4] days; p Ͻ.0001). Voiding dysfunction was an independent predictor of postoperative urinary tract infection (OR 4.9; 95% CI 1.6-15.4). CONCLUSION: Patients undergoing VH are more likely to develop postoperative voiding dysfunction than those who undergo TLH, when a policy of immediate catheter removal after surgery is used.
Urodynamic changes following laparoscopic versus vaginal hysterectomy
Archivio Italiano di Urologia e Andrologia
Objective: To compare urodynamic changes before and after hysterectomy (laparoscopic vs. vaginal approach) for benign gynecological diseases.Patients and methods: A total of 90 women with a mean age of 56.36-years were enrolled in this study between August 2019 and April 2021. They were divided into two equal groups(45 patients each). Group, I had a vaginal hysterectomy, and Group II had a laparoscopic hysterectomy. All patients were assessed clinically using ICIQ-FLUTS questionnaire and a uro-dynamic study before and six months after surgery. Results: Both vaginal and laparoscopic hysterectomy did not significantly change the maximum flow rate, voiding time, and average flow rate. The increase in residual urine volume in group I was not significant (p = 0.129), as was in Group II(p = 0.217). All the modifications, however, were within permis-sible limits. According to the cystometry result, volume at initial sensation rose in both groups after surgery, with no statistically significant d...
Indonesian Journal of Obstetrics and Gynecology, 2016
Objective: To assess and compare the incidence of urinary retention in patients post-vaginal and abdominal total hysterectomy for benign gynecological disorders. Method: This is a comparative analytical study with prospective and retrospective cohort design, which was conducted in Dr. Cipto Mangunkusumo Hospital and Persahabatan Hospital from June 2012 to February 2014. Result: We recruited thirty-eight research subjects who underwent abdominal hysterectomy, and 18 subjects who underwent vaginal hysterectomy. The majority of cases underwent the procedure for abnormal uterine myoma (55.5%) and adenomyosis (28.9%). Incidence of urinary retention post-hysterectomy was 33.3% for vaginal hysterectomy, and 31.6% for abdominal hysterectomy. The comparison of the incidence of urinary retention showed no difference between vaginal and abdominal hysterectomies (RR=1.056). Conclusion: Vaginal hysterectomy does not increase the incidence of postoperative urinary retention. However, this study suggests the need for further research with a larger sample size, employing prospective cohort design, with preoperative measurement of postvoiding urine volume (PVR).
Pelvic organ function in randomized patients undergoing laparoscopic or abdominal hysterectomy
Journal of Minimally Invasive Gynecology, 2007
STUDY OBJECTIVE: To assess the incidence of urinary incontinence, bowel dysfunction, and sexual problems after laparoscopic hysterectomy as compared with abdominal hysterectomy. DESIGN: Randomized controlled trial (Canadian Task Force classification I). SETTING: Single-center teaching hospital in the Netherlands, experienced in gynecologic minimal access surgery.
Short-term voiding patterns after vaginal hysterectomy and pelvic floor repair
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2022
Background: Post-operative transient voiding dysfunction is a known complication of vaginal hysterectomy (VH) with pelvic floor repair (PFR). This study aims to determine the duration of urinary catheterization prior to resumption of normal voiding and hospital length of stay for patients who have undergone VH, PFR with or without concomitant application of transvaginal mesh (TVM) and/or mid-urethral sling (MUS).Methods: This is a retrospective cohort study of women who underwent VH with PFR at a single urogynaecology centre in Singapore between 01 October 2016 and 30 September 2017. Patients’ files were reviewed for data collection and analysis.Results: A total of 238 women with VH with PFR were studied, of whom 68 (28.6%) did not have any implant, 60 (25.2%) had only TVM, 50 (21.0%) had only MUS, and 60 (25.2%) had both TVM and MUS. Overall, 1/68 (1.5%) patients without implants, 16/110 (14.5%) patients with one implant and 13/60 (21.7%) patients with two implants failed at least ...
Chinese journal of cancer research = Chung-kuo yen cheng yen chiu, 2016
To evaluate the short-term and long-term outcomes after laparoscopic hysterectomy (LH) compared with abdominal hysterectomy (AH) in case of benign gynecological disease. A multi-center cohort retrospective comparative study of population among 4,895 hysterectomies (3,539 LH vs.1,356 AH) between 2007 and 2013 was involved. Operative time (OT), estimated blood loss (EBL), intra-operative and post-operative complications, passing flatus; days with indwelling catheter, questionnaires covering pelvic floor functions and sexual functions were assessed. The EBL (174.1±157.4 vs. 263.1±183.2 cc, LH and AH groups, respectively), passing flatus (38.7±14.1 vs. 48.1±13.2 hours), days with indwelling catheter (1.5±0.6 vs. 2.2±0.8 days), use of analgesics (6.5% vs. 73.1%), intra-operative complication rate (2.4% vs. 4.1%), post-operative complication rate (2.3% vs. 5.7%), post-operative constipation (12.1% vs. 24.6%), mild and serious stress urinary incontinence (SUI) post-operative (P<0.001; P...
The short-term prevalence of de novo urinary symptoms after different modes of hysterectomy
The aim of this study was to determine the short-term prevalence of de novo urinary symptoms after hysterectomy indicated by meno/metrorrhagia or dysmenorrhea/dyspareunia. The study group consisted of 451 women who had had a hysterectomy for reasons of meno/metrorrhagia or dysmenorrhea/dyspareunia. Fifty-three (12%) had a supracervical, 151 (33%) a total abdominal and 247 (55%) a vaginal hysterectomy. As a non-gynecologic background population we enrolled 110 women who had had their gallbladder removed laparoscopically. All women received a postal questionnaire 9–45 months after their operation. Specific questions were asked about their voiding habits, comprising significant stress incontinence, bothersome stress incontinence, significant urge incontinence, bothersome urge incontinence, pollakisuria, nocturia, use of pads, and the feeling of having a hygiene problem. To evaluate de novo symptoms or de novo cure, the women assessed the symptoms before as well as after the operation. Results showed that abdominal hysterectomy lasted longer, had heavier blood loss and required longer hospitalization than did vaginal or supracervical hysterectomy. Women scheduled for a supracervical hysterectomy had preoperatively more significant and bothersome urge incontinence, and postoperatively more significant urge, urgency, and feeling of having a hygienic problem than did women having a vaginal hysterectomy, a total abdominal hysterectomy or a laparoscopic cholecystectomy. When assessing de novo symptoms, supracervical hysterectomy was associated with more urgency and the feeling of having a hygienic problem. Some women experienced de novo cure, but these were almost exclusively in the study group and rarely in the control group. It was concluded that supracervical hysterectomy is related to more urinary symptoms than vaginal or total abdominal hysterectomy. De novo symptoms as well as de novo cure are common, which is why urinary symptoms after hysterectomy must be evaluated over time.
American Journal of Obstetrics and Gynecology, 2008
Objective: A metaanalysis of randomized trials was conducted to evaluate if the type of hysterectomy, total abdominal hysterectomy or supracervical hysterectomy, has an impact on the development of urinary incontinence. Study Design: We searched MEDLINE, EMBASE, CINAHL, Biological Abstract, and the Cochrane Library up to February 2007; abstracts at major meetings and bibliographies of retrieved articles were scanned. A fixed effect model was used to calculate summary relative risk estimates and 95% confidence intervals (CIs). Results: Analysis showed no statistical difference in the risk of developing stress or urge urinary incontinence in women who underwent supracervical hysterectomy compared with women who underwent total abdominal hysterectomy (relative risk, 1.3; 95% CI, 0.94-1.78; P = 0.16 and relative risk, 1.37; 95% CI, 0.77-2.46; P = 0.25). Conclusion: There is no statistical evidence of a different risk for developing either stress or urge urinary incontinence after a supracervical hysterectomy or a total hysterectomy. Editorial Comment The authors noted a current trend towards supracervical hysterectomy as opposed to a total hysterectomy in an effort to diminish surgical impact on underlying patient anatomic structures that involve continence. The authors performed a meta-analysis to gather their data: this spanned relevant articles between 1996 and 2007, ongoing clinical trials, and abstracts performed on the topic. They specifically reviewed comparison of total abdominal hysterectomy and supracervical hysterectomy with regards the development of stress or urinary urge incontinence. The authors noted that there was no difference between supracervical hysterectomy and total hysterectomy with regards to voiding dysfunction (stress urinary incontinence, urinary urge incontinence or symptoms of overactive bladder). In fact, they noted that there was a non-significant trend towards increased risk for voiding dysfunction with a supracervical hysterectomy as opposed to total abdominal hysterectomy. This study highlights the difference between anecdotal and observational notations versus scientific analysis. Their findings of a non-statistical increase in supracervical approach associated voiding dysfunction as opposed to total abdominal hysterectomy may temper the enthusiasm for the completion of this operation sheerly based on the perception of preventing future voiding dysfunction. As pointed out by the authors, the difficulty in comparing the efficacy of observational studies versus scientific studies is that the former may be performed as an accumulation of experience over a career while the latter may involve a follow-up of significantly less time.
PurposeTransient postoperative urinary retention (POUR) is common after pelvic floor surgery. We aimed to determine the association between peri-operative variables and POUR and to determine the number of voids required for post-void residuals (PVRs) to normalize postoperatively. MethodsWe conducted a retrospective cohort study of 992 patients undergoing pelvic floor surgery at a tertiary referral centre from January 2015-October 2017. Variables assessed included: age, BMI, ASA score, anaesthesia type, type of surgery, length of postoperative stay, surgeon, bladder protocol used, and number of PVRs required to “pass” the protocol. Results Significant risk factors for POUR included: placement of MUS during POP surgery, anterior repair and hysterectomy with concomitant sacrospinous vault suspension.A total of 25.1% were discharged requiring catheterization. Patients receiving a concomitant mid-urethral sling (MUS) were 2.2 (95% CI:1.6-2.9) and 2.3 (95% CI:1.8-3.1) times more likely to...
International Urogynecology Journal, 1991
Lower urinary tract function was evaluated by means of clinical and urodyfiamic assessment in a prospective randomized study including 31 patients undergoing two different types of extended hysterectomy [1] for cervical cancer. In the immediate postoperative period loss of both bladder sensitivity and detrusor voiding activity with reduced compliance was observed in 60% of patients regardless of the operative procedure performed. At 3 months follow-up, the improvement in urethrovesical function was significantly related to a less extensive dissection of pelvic connective tissue (P<0.01).