Clinical predictors of urinary retention after pelvic reconstructive and stress urinary incontinence surgery.
OBJECTIVE
To evaluate the impact of perioperative variables on length of postoperative catheterization.


METHODS
A multicenter, prospective, cohort study of women undergoing pelvic reconstructive and/or incontinence surgery was performed. Perioperative variables associated with length of catheterization and prolonged catheterization (catheterization >30 days) were analyzed. Univariate logistic regression was used identify variables associated with urinary retention. Multivariate logistic regression analysis was performed on variables identified by univariate analysis to construct the best model predicting prolonged postoperative catheterization.


RESULTS
Catheterization data were available for 408 patients. Mean catheterization length was 11 +11 days. Thirty-four patients required prolonged catheterization. Logistic regression analysis selected 3 variables as predictors of prolonged catheterization: performance of pubovaginal sling (OR 5.44), performance of vaginal apex suspension (OR 2.32) and preoperative presence of grade 3/4 vaginal apex descent (OR 2.75) (all p < or =0.05). The probability of prolonged catheterization occurring in the absence of any of the predictors was 2% and increased to 5-11% if 1 predictor was present. When all 3 were present, the probability of prolonged catheter use increased to 45%.


CONCLUSIONS
The performance of a pubovaginal sling and of a vaginal apex suspension or the preoperative presence of grade 3/4 vaginal apex descent are associated with prolonged postoperative catheterization.
Komesu
Yuko M
YM
Division of Female Pelvic Floor Disorders, Dept. of Obstetrics and Gynecology, University of New Mexico Health Sciences Center and Dept. of Obstetrics and Gynecology, Lovelace Health Systems, Albuquerque, New Mexico 87131-5286, USA. ykomesu@salud.unm.edu
Rogers
Rebecca G
RG
Kammerer-Doak
Dorothy N
DN
Olsen
Ambre L
AL
Thompson
Peter K
PK
Walters
Mark D
MD
D000328:Adult; D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D019736:Prostheses and Implants; D014546:Urinary Catheterization / Q000009:adverse effects*; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D016055:Urinary Retention / Q000209:etiology*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D014621:Vagina / Q000601:surgery