Voiding after Burch colposuspension and effects of concomitant pelvic surgery: correlation with preoperative voiding mechanism.
OBJECTIVE
To determine if concomitant abdominal hysterectomy, posterior colporrhaphy, or preoperative voiding mechanism adversely affect the duration of voiding dysfunction experienced after Burch colposuspension.


METHODS
A retrospective review was conducted of 154 consecutive women with genuine stress incontinence managed by Burch colposuspension over 4 years. Fifty-three (35%) women underwent colposuspension alone, 33 (22%) underwent colposuspension with posterior colpoperineorrhaphy, and 68 (44%) underwent colposuspension with total abdominal hysterectomy (TAH). A suprapubic Foley catheter was placed after all operations and removed when the post-void residual urine reached 20% or less of the volume voided on two consecutive attempts.


RESULTS
Women who underwent colposuspension alone, colposuspension with posterior colpoperineorrhaphy, and colposuspension with TAH required a mean duration of 4.3, 4.3, and 4.8 days of postoperative bladder drainage, respectively. These differences were not statistically significant. Women who voided with Valsalva maneuver without a detrusor contraction took significantly longer to resume normal micturition than did those who voided with a detrusor contraction with or without Valsalva maneuver, or urethral relaxation alone (mean 9.0 days compared with 3.6, 4.7, and 4.8 days, respectively; P < .001).


CONCLUSIONS
Concomitant abdominal hysterectomy or posterior colpoperineorrhaphy did not prolong voiding dysfunction after colposuspension. Women who voided with Valsalva maneuver and without a detrusor contraction took significantly longer to resume normal micturition after Burch colposuspension with or without concomitant TAH.
Sze
E H
EH
Department of Obstetrics and Gynecology, Good Samaritan Hospital, University of Cincinnati, Ohio, USA.
Miklos
J R
JR
Karram
M M
MM
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D014521:Urethra / Q000503:physiopathology; D001743:Urinary Bladder / Q000503:physiopathology / Q000601:surgery; D014546:Urinary Catheterization; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D014554:Urination; D014555:Urination Disorders / Q000209:etiology; D014563:Urodynamics; D014636:Valsalva Maneuver