Urinary retention after AdVance™ Sling: A multi-institutional retrospective study
| Autor: | Arthur Mourtzinos, Ross Rames, Eric S. Rovner, Sender Herschorn, Sarah Neu, Jennifer A. Locke, Michael J. Metro, Hailey Silverii, Goran Rac, Yu Zheng, Lauren Rittenberg, Matthew Moynihan, Jennifer Rolef, Lindsey Cox, Ouida Lenaine Westney, Nicholas Major |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Sling (implant) Urology Urinary Incontinence Stress 030232 urology & nephrology Urinary incontinence 03 medical and health sciences 0302 clinical medicine Medicine Humans Aged Retrospective Studies Suburethral Slings 030219 obstetrics & reproductive medicine business.industry Urinary retention Significant difference Retrospective cohort study Odds ratio Advance sling Urinary Retention Confidence interval Female Neurology (clinical) medicine.symptom business |
| Zdroj: | Neurourology and urodynamicsREFERENCES. 40(1) |
| ISSN: | 1520-6777 |
| Popis: | Aims To identify risk factors for urinary retention following AdVance™ Sling placement using preoperative urodynamic studies to evaluate bladder contractility. Methods A multi-institutional retrospective review of patients who underwent an AdVance Sling for post-prostatectomy stress urinary incontinence from 2007 to 2019 was performed. Acute urinary retention (AUR) was defined as the complete inability to void or elevated post-void residual (PVR) leading to catheter placement or the initiation of intermittent catheterization at the first void trial postoperatively. Bladder contractility was evaluated based on preoperative urodynamics. Results Of the 391 patients in this study, 55 (14.1%) experienced AUR, and 6 patients (1.5%) had chronic urinary retention with a median follow-up of 18.1 months. In total, 303 patients (77.5%) underwent preoperative urodynamics, and there was no significant difference between average PdetQmax (26.4 vs. 27.4 cmH2 O), Qmax (16.6 vs. 16.2 ml/s), PVR (19.9 vs. 28.1 ml), bladder contractility index (108 vs. 103) for patients with or without AUR following AdVance Sling. Impaired bladder contractility preoperatively was not predictive of AUR. Time to postoperative urethral catheter removal was predictive of AUR (odds ratio, 0.83; 95% confidence interval, 0.73-0.94; p = .003). Conclusions Chronic urinary retention after AdVance Sling placement is uncommon and acute retention is generally self-limiting. No demographic or urodynamic factors were predictive of AUR. Patients who developed AUR were more likely to have their void trials within 2 days following AdVance Sling placement versus longer initial catheterization periods, suggesting that a longer duration of postoperative catheterization may reduce the occurrence of AUR. |
| Databáze: | OpenAIRE |
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