title: The importance of studying pressure-flow for predicting postoperative voiding difficulties in women with stress urinary incontinence: a preliminary study that correlates low Pdet x Qave with postoperative residual urine.
abstract: We evaluated the parameters of preoperative pressure-flow for predicting the postoperative voiding difficulties in women with stress urinary incontinence. The preoperative urodynamic study records of 14 women treated using the tension-free vaginal tape (TVT) procedure were retrospectively analyzed. Of the patients treated with the TVT procedure, urinary retention occurred in one patient, and three had a residual urine volume of more than 30 ml. All patients became completely free of stress urinary incontinence postoperatively. The lowest Pdet max (5 cmH(2)O) in the preoperative pressure-flow study was found in a patient with a remarkable postoperative residual urine volume of more than 50 ml. The second lowest Pdet max value (8 cmH(2)O) was seen in a patient with postoperative urinary retention, whose residual urine volume, however, decreased to almost zero 1 year after the operation. The preoperative Pdet max x Qave values were remarkably low for these three patients, including the one with the lowest Pdet max, with a post-void residual urine volume of more than 30 ml. The plots of Pdet max x Qave versus the age of patients show that the Pdet max x Qave values tend to decrease with aging. The preoperative Pdet max x Qave value can be an important parameter for predicting increased residual urine after TVT sling surgery.
authors.affiliation: Department of Urology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abenoku, Osaka 545-8585, Japan. hidenori@msic.med.osaka-cu.ac.jp
authors.forename: Hidenori
authors.initials: H
authors.lastname: Kawashima
authors.forename: Kouzo
authors.initials: K
authors.lastname: Hirai
authors.forename: Noboru
authors.initials: N
authors.lastname: Okada
authors.forename: Yuki
authors.initials: Y
authors.lastname: Takahara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kurisu
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Sumi
authors.forename: Tomoyo
authors.initials: T
authors.lastname: Yasui
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishiko
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nakatani
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D011312:Pressure; D012189:Retrospective Studies; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D016055:Urinary Retention / Q000209:etiology*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000009:adverse effects*