Orawee Chinthakanan MD, MPH1, Alin Petcharopas MD2, Rujira Wattanayingcharoenchai MD1, Jittima Manonai MD1, Komkrit Aimjirakul MD1
Affiliation : 1 Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Ramathibodi Hospital,
Mahidol University, Bangkok, Thailand
2 Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Objective : To determine the prevalence of postoperative urinary retention following pelvic (cid:976)loor surgery, identify risks associated
with pelvic (cid:976)loor surgery, and determine the optimal duration of transurethral urinary catheterization after pelvic (cid:976)loor surgery.
Materials and Methods : This retrospective cohort study included women aged 35 to 85 years diagnosed with pelvic organ prolapse
[POP] and urinary incontinence [UI] who underwent pelvic (cid:976)loor surgical correction between January 2009 and December 2016
at a tertiary referral center.
Results : The authors identi(cid:976)ied 542 potential participants who underwent pelvic (cid:976)loor surgery. Of these, 161 were excluded due
to lack of data, and 381 medical charts were studied. The mean age of selected participants was 66.0±9.1 years. Most patients
were menopausal (95%), 13.5% had previously undergone hysterectomy, and 11.4% had previously suffered from incontinence
or undergone prolapse surgery. Most patients (82.4%) had stage 3 or 4 POP and 24.9% experienced UI before surgery. Almost 7%
(28/418) of patients experienced postoperative urinary retention and required insertion of a Foley catheter. All patients returned
to normal after 7 to 10 days. Patients who had previously undergone a hysterectomy were more likely to experience postoperative
urinary retention (28.6% versus 12.3%, p = 0.02). Operative procedures were not statistically different between urinary retention
and non-urinary retention groups. A statistical difference in urinary retention rate was not observed when comparing placement
of a Foley catheter for 24 hours versus more than 24 hours (9.1% versus 6.4%, p = 0.5, RR 1.5, 95% CI 0.48 to 4.42).
Conclusion : The rate of postoperative urinary retention after pelvic (cid:976)loor surgery was approximately 7%. There was no signi(cid:976)icant
correlation between surgical procedure and postoperative urinary retention outcomes. The optimal duration for placement of a
Foley catheter was 24 hours. This protocol will reduce hospital stay duration and associated costs. Therefore, catheter removal 24
hours after pelvic (cid:976)loor surgery is recommended.
Keywords : Urinary retention, Pelvic (cid:976)loor surgery, Urinary catheterization
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