title: Preoperative Valsalva voiding increases the risk of urinary retention after midurethral sling placement.
abstract: 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.
authors.affiliation: Department of Urology, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA.
authors.forename: Khanh N
authors.initials: KN
authors.lastname: Pham
authors.forename: Nicole
authors.initials: N
authors.lastname: Topp
authors.forename: Michael L
authors.initials: ML
authors.lastname: Guralnick
authors.forename: Sumana
authors.initials: S
authors.lastname: Koduri
authors.forename: Julianne R
authors.initials: JR
authors.lastname: Newcomer
authors.forename: Robert Corey
authors.initials: RC
authors.lastname: O'Connor
mesh_terms: 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*