Predicting short-term urinary retention after vaginal prolapse surgery.
OBJECTIVE
Identification of risk factors for urinary retention after vaginal prolapse surgery.


METHODS
The medical records of 345 women undergoing surgical correction for symptomatic pelvic organ prolapse were analyzed. Independent risk factors for the development of post-operative urinary retention were identified by performing univariate and multivariate logistic regression analysis. Variables included in the analysis were age, parity, body mass index, previous prolapse surgery, previous hysterectomy, menopausal status, degree of prolapse, type of anesthesia, type and technique of surgery, operation time, intra-operative blood loss, preoperative urinary stress-incontinence, and other co-morbidities. Main outcome measure was the occurrence of urinary retention defined as a residual volume after voiding higher than 200 ml as measured by bladder scan.


RESULTS
High grade cystocele (OR 2.5, CI 1.3-4.7), performing levator plication (OR 4.3, CI 2.0-9.3), performing Kelly plication (OR 5.1, CI 1.7-15.5) and amount of intra-operative blood loss (OR 1.4 per 100 ml, CI 1.1-1.8) were identified as independent risk factors for the occurrence of urinary retention after vaginal prolapse surgery.


CONCLUSIONS
Urinary retention after vaginal prolapse surgery occurs more frequently in women with larger cystoceles, severe intra-operative blood loss and the application of levator plication and Kelly plication.
Hakvoort
Robert A
RA
Department of Obstetrics and Gynaecology, Spaarne Hospital, Hoofddorp, The Netherlands. rhakvoort@spaarneziekenhuis.nl
Dijkgraaf
Marcel G
MG
Burger
Matthe P
MP
Emanuel
Mark H
MH
Roovers
Jan Paul W R
JP
D000368:Aged; D016063:Blood Loss, Surgical; D052858:Cystocele / Q000601:surgery; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007430:Intraoperative Care; D008875:Middle Aged; D015999:Multivariate Analysis; D017773:Pelvic Floor / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D014546:Urinary Catheterization; D016055:Urinary Retention / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D014596:Uterine Prolapse / Q000175:diagnosis / Q000601:surgery*