| Popis: |
Background: To systematically review and meta-analyze postoperative void trials (VTs) following urogynecologic surgery to investigate (1) the optimal postoperative VT methodology and (2) the optimal criteria for assessing VT. Method: We searched the PubMed, EMBASE, Cochrane Library, Ovid Medline, and relevant reference lists of eligible articles up to April 2022. This review included randomized controlled trials (RCTs). Relative risks (RRs) and weighted mean differences (WMDs), each with 95% confidence intervals (CIs) were also calculated. The risk of bias was assessed using the Cochrane Risk of Bias tool. Results: VT methodology included backfill-assisted and autofill studies (two RCTs, n=95). Backfill assistance was more likely to be successful than autofill (RR 2.12, 95% CI 1.29, 3.47, P = .00); however, no significant difference was found in the time to discharge (WMDs= –29.11 min, 95% CI -57.45, 1.23, P = .06). Criteria for passing VT included subjective assessment of the urinary force of stream (FOS) and objective assessment of the standard voiding trial (SVT) (3 RCTs, n=377). No significant differences were found in the correct passing rate (RR 0.97, 95% CI 0.93, 1.01, P = .14) or VT failure rate (RR 0.78, 95% CI 0.52,1.18, P = .24). Moreover, no significant differences were found in the complication rates orpatient satisfaction between the two criteria. Conclusion: Bladder backfilling was associated with a lower rate of catheter discharge after urogynecologic surgery. The subjective assessment of FOS is a reliable and safe method for assessing postoperative voiding because it is less invasive. Systematic review registration: PROSPERO CRD42022313397. |
