Preoperative Valsalva voiding increases the risk of urinary retention after midurethral sling placement.
OBJECTIVE
A subset of neurologically normal females void by efficient Valsalva, not detrusor contraction. We determined the incidence of urinary retention following midurethral sling (MUS) placement in women that void by detrusor contraction versus Valsalva.


METHODS
Review of patients undergoing MUS insertion between 2002 and 2009 for urodynamic stress incontinence was performed. Women with concomitant pelvic surgery, previous incontinence surgery, or preoperative incomplete bladder emptying were excluded. Patients were divided into two cohorts based on preoperative urodynamic findings--those that voided with a detrusor contraction >10 cm of water and those that voided by Valsalva.


RESULTS
One hundred seven patients were available for analysis. The postoperative urinary retention rate was 22% and 5% in the Valsalva and non-Valsalva groups, respectively (p < 0.05). Mean retention duration was 3 weeks for each cohort (range 1-6).


CONCLUSIONS
Women voiding by Valsalva are at increased risk of urinary retention following MUS placement.
Pham
Khanh N
KN
Department of Urology, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA.
Topp
Nicole
N
Guralnick
Michael L
ML
Koduri
Sumana
S
Newcomer
Julianne R
JR
O'Connor
Robert Corey
RC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D053825:Suburethral Slings / Q000009:adverse effects*; D016055:Urinary Retention / Q000453:epidemiology* / Q000209:etiology*; D014554:Urination / Q000502:physiology*