Factors predictive of urinary retention after a tension-free vaginal tape procedure for female stress urinary incontinence.
OBJECTIVE
We performed this study to evaluate factors related to urinary retention after a tension-free vaginal tape (TVT) procedure for female stress urinary incontinence.


METHODS
We retrospectively analyzed the records of 375 women with a followup of at least 6 months from among patients who underwent the TVT procedure between March 1999 and May 2002 at our institution. We analyzed multiple parameters, including patient characteristics, symptoms and urodynamic studies, using univariate and multivariate regression analyses with respect to postoperative urinary retention, as defined by the need for intermittent catheterization for at least 3 days after the procedure. All patients in the nonretention (343) and retention (32) groups answered a global satisfaction question.


RESULTS
In answer to a global satisfaction question 338 of the 375 patients (90.1%) favored the procedure. Univariate analysis demonstrated that patient mean age, parity, peak urinary flow and a history of hysterectomy predicted urinary retention. However, on multivariate analyses the peak urinary flow rate was the only significant independent predictive factor (p = 0.007). While 28 patients (87.5%) in the retention group regained normal voiding without a specific procedure, 4 required tape release or cutting within 3 month of surgery. The global satisfaction question showed a significant difference between the nonretention and retention groups (91.5% vs 75% satisfaction, p = 0.03).


CONCLUSIONS
An accurate measurement of the peak urinary flow rate could predict women at risk for postoperative urinary retention that compromises global satisfaction after the highly curative TVT procedure.
Hong
Bumsik
B
Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Park
Sungchan
S
Kim
Hong Sik
HS
Choo
Myung-soo
MS
D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D019736:Prostheses and Implants; D012372:ROC Curve; D012044:Regression Analysis; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D016055:Urinary Retention / Q000209:etiology* / Q000503:physiopathology; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000009:adverse effects*