title: Predictors of postoperative acute urinary retention in women undergoing minimally invasive sacral colpopexy.
abstract: OBJECTIVE
  Our aim was to determine predictors of acute urinary retention in women undergoing laparoscopic and robotic sacral colpopexy.
  
  
  METHODS
  Records from all minimally invasive sacral colpopexies performed from 2009 to 2012 were reviewed. All women had a retrograde fill voiding trial (RGVT) on postoperative day 1, except in cases of intraoperative bladder injury or chronic urinary retention. Patient demographics, medical comorbidities, and surgical factors were compared between women who did and did not pass the RGVT. Univariable and multivariable logistic regression analyses were used to identify predictors of postoperative voiding dysfunction.
  
  
  RESULTS
  Three hundred two subjects met the inclusion criteria, but 12 were excluded because of planned prolonged catheterization. Of the remaining 290 subjects, 211 (72.8%) passed the RGVT. The mean (SD) for the duration of urinary retention in those who failed was 3.7 (4.2) days. The mean (SD) for age was 58.5 (8.6) years, and the median preoperative prolapse was Pelvic Organ Prolapse Quantification stage III (76.1% with ≥ stage III) with mean Ba = +2.3. There were no significant independent risk factors identified on multivariable logistic regression to predict RGVT failure, with only concurrent midurethral sling approaching significance (6.1% vs 12.5%; adjusted odds ratio, 2.25; 95% confidence interval, 0.93-5.45; P = 0.07).
  
  
  CONCLUSIONS
  No significant predictors of acute urinary retention were identified among women undergoing minimally invasive sacral colpopexy. In contrast to published analyses of vaginal prolapse repairs, large preoperative cystocele and concurrent midurethral sling were not significantly associated with retention. Given the inability to predict who will have postoperative urinary retention, all patients should be counseled about the potential need for catheterization.
authors.affiliation: From the Division of Urogynecology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: Lindsay C
authors.initials: LC
authors.lastname: Turner
authors.forename: Kelly
authors.initials: K
authors.lastname: Kantartzis
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Shepherd
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D012307:Risk Factors; D065287:Robotic Surgical Procedures / Q000009:adverse effects*; D012447:Sacrum / Q000601:surgery; D053825:Suburethral Slings / Q000009:adverse effects; D013997:Time Factors; D016055:Urinary Retention / Q000209:etiology*; D014554:Urination; D014621:Vagina / Q000601:surgery