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Preoperative urodynamic evaluation may predict voiding dysfunction in women undergoing pubovaginal sling.
J Urol. 2003 Jun; 169(6):2234-7.JU

Abstract

PURPOSE

We determine which urodynamic parameters can best predict postoperative voiding dysfunction following pubovaginal sling surgery.

MATERIALS AND METHODS

The records of 98 consecutive women who had undergone pubovaginal sling surgery with allograft fascia lata between July 1998 and July 2000 were reviewed. Urodynamic and followup data were sufficient for evaluation for 73 patients. Urodynamic and clinical parameters were correlated with urinary retention, time to return of efficient voiding and development of postoperative urgency symptoms.

RESULTS

Average time to return of efficient voiding was 3.92 days (median 3). Of 21 women who voided without a detrusor contraction urinary retention developed in 4 (23%) versus 0 of 48 who voided with detrusor contraction (p = 0.007). Urinary retention was defined as the need to perform even occasional self-catheterization. All 4 women with urinary retention had a detrusor pressure of less than 12 cm. H(2)O (0 in 3, 4 in 1). None of the women with a detrusor pressure of greater than 12 cm. H(2)O had urinary retention (p = 0.047). The presence of Valsalva voiding in women without a detrusor contraction did not affect the incidence of urinary retention (11.1%) compared to those who did not demonstrate Valsalva voiding (5.1%) (p = 0.603). Peak flow rate, detrusor instability on preoperative urodynamics and post-void residual urine volume were not associated with postoperative urinary retention. Finally, post-void residual urine volume predicted delayed return to normal voiding (p = 0.001). There were no other urodynamic parameters that were significantly associated with urinary retention, delayed return to normal voiding or postoperative urgency symptoms including peak flow rate, capacity or compliance.

CONCLUSIONS

Women who void without or with a weak detrusor contraction are most likely to have urinary retention postoperatively. Therefore, we conclude that preoperative urodynamic evaluation may be used to counsel women regarding the risk of urinary retention following the pubovaginal sling procedure.

Authors+Show Affiliations

Department of Urology, University of Washington Medical Center, Seattle, Washington, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12771757

Citation

Miller, Elizabeth A., et al. "Preoperative Urodynamic Evaluation May Predict Voiding Dysfunction in Women Undergoing Pubovaginal Sling." The Journal of Urology, vol. 169, no. 6, 2003, pp. 2234-7.
Miller EA, Amundsen CL, Toh KL, et al. Preoperative urodynamic evaluation may predict voiding dysfunction in women undergoing pubovaginal sling. J Urol. 2003;169(6):2234-7.
Miller, E. A., Amundsen, C. L., Toh, K. L., Flynn, B. J., & Webster, G. D. (2003). Preoperative urodynamic evaluation may predict voiding dysfunction in women undergoing pubovaginal sling. The Journal of Urology, 169(6), 2234-7.
Miller EA, et al. Preoperative Urodynamic Evaluation May Predict Voiding Dysfunction in Women Undergoing Pubovaginal Sling. J Urol. 2003;169(6):2234-7. PubMed PMID: 12771757.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preoperative urodynamic evaluation may predict voiding dysfunction in women undergoing pubovaginal sling. AU - Miller,Elizabeth A, AU - Amundsen,Cindy L, AU - Toh,Khai Lee, AU - Flynn,Brian J, AU - Webster,George D, PY - 2003/5/29/pubmed PY - 2003/6/11/medline PY - 2003/5/29/entrez SP - 2234 EP - 7 JF - The Journal of urology JO - J Urol VL - 169 IS - 6 N2 - PURPOSE: We determine which urodynamic parameters can best predict postoperative voiding dysfunction following pubovaginal sling surgery. MATERIALS AND METHODS: The records of 98 consecutive women who had undergone pubovaginal sling surgery with allograft fascia lata between July 1998 and July 2000 were reviewed. Urodynamic and followup data were sufficient for evaluation for 73 patients. Urodynamic and clinical parameters were correlated with urinary retention, time to return of efficient voiding and development of postoperative urgency symptoms. RESULTS: Average time to return of efficient voiding was 3.92 days (median 3). Of 21 women who voided without a detrusor contraction urinary retention developed in 4 (23%) versus 0 of 48 who voided with detrusor contraction (p = 0.007). Urinary retention was defined as the need to perform even occasional self-catheterization. All 4 women with urinary retention had a detrusor pressure of less than 12 cm. H(2)O (0 in 3, 4 in 1). None of the women with a detrusor pressure of greater than 12 cm. H(2)O had urinary retention (p = 0.047). The presence of Valsalva voiding in women without a detrusor contraction did not affect the incidence of urinary retention (11.1%) compared to those who did not demonstrate Valsalva voiding (5.1%) (p = 0.603). Peak flow rate, detrusor instability on preoperative urodynamics and post-void residual urine volume were not associated with postoperative urinary retention. Finally, post-void residual urine volume predicted delayed return to normal voiding (p = 0.001). There were no other urodynamic parameters that were significantly associated with urinary retention, delayed return to normal voiding or postoperative urgency symptoms including peak flow rate, capacity or compliance. CONCLUSIONS: Women who void without or with a weak detrusor contraction are most likely to have urinary retention postoperatively. Therefore, we conclude that preoperative urodynamic evaluation may be used to counsel women regarding the risk of urinary retention following the pubovaginal sling procedure. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/12771757/Preoperative_urodynamic_evaluation_may_predict_voiding_dysfunction_in_women_undergoing_pubovaginal_sling_ L2 - https://www.jurology.com/doi/10.1097/01.ju.0000063590.13100.4d?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -