Postoperative Urinary Retention after Benign Gynecologic Surgery with a Liberal versus Strict Voiding Protocol
| Autor: | Matthew T. Siedhoff, Meenal Misal, Naomi Greene, Andrea L. Molina, Kelly N. Wright |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Urinary system Urination Subgroup analysis Malignancy Article Cohort Studies 03 medical and health sciences Gynecologic Surgical Procedures Postoperative Complications 0302 clinical medicine Interquartile range medicine Humans Minimally Invasive Surgical Procedures Postoperative Period Laparoscopy Retrospective Studies 030219 obstetrics & reproductive medicine Hysterectomy medicine.diagnostic_test Urinary retention business.industry Obstetrics and Gynecology Retrospective cohort study Length of Stay Middle Aged Urinary Retention medicine.disease Patient Discharge United States Surgery 030220 oncology & carcinogenesis Female medicine.symptom business Genital Diseases Female |
| Zdroj: | J Minim Invasive Gynecol |
| ISSN: | 1553-4650 |
| DOI: | 10.1016/j.jmig.2020.07.002 |
| Popis: | STUDY OBJECTIVE: Surgeons employ various methods for evaluating what is considered a common occurrence after gynecologic operations, postoperative urinary retention (POUR). Few have reported the incidence of POUR with a liberal voiding protocol (no requirement to void prior to discharge). The primary objective of this study is to evaluate the risk of POUR after benign gynecologic surgery, comparing a liberal voiding protocol to more strict voiding protocols. Secondary outcomes include length of hospital stay and urinary tract infection (UTI). DESIGN: Retrospective cohort study. SETTING: Quaternary-care academic hospital in the United States. PATIENTS: Patients undergoing hysterectomy or myomectomy at Cedars-Sinai Medical Center from August 2017 through July 2018 (n=652). Cases involving incontinence operations, correction of pelvic organ prolapse, malignancy, or peripartum hysterectomy were excluded. INTERVENTIONS: Hysterectomy, myomectomy MEASUREMENTS AND MAIN RESULTS: POUR, defined as the need for re-catheterization within 24 hours of catheter removal, along with UTI and length of stay, were compared between liberal and strict voiding protocols. Sub-group analysis was performed for those undergoing minimally invasive surgery (MIS). 303 (46.5%) women underwent surgery with a liberal postoperative voiding protocol and 349 (53.5%) with a strict voiding protocol. Overall, the incidence of POUR was low at 3.8% and not different among groups (2.6% liberal vs. 4.9% strict, p = 0.14). UTI also occurred infrequently (2.8% overall, 2.6% liberal vs. 2.9% strict, p= 0.86). Similar results were seen specifically among those that underwent MIS: POUR (3.7% overall, 2.8% liberal vs. 5.3% strict, p= 0.17) and UTI (3.3% overall, 2.4% liberal vs. 4.7% strict, p= 0.28). Median length of stay (IQR) was much shorter for MIS patients with a liberal voiding protocol (median 15 hours overall (IQR 15 hours), 9 (4) liberal vs. 36 (34) strict, p |
| Databáze: | OpenAIRE |
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