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Prevalence of Postoperative Urinary Retention and the Optimal Duration of Transurethral Urinary Catheterization after Pelvic Floor Surgery

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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