title: Two techniques for assessing postoperative voiding function, a randomized trial.
abstract: OBJECTIVE
  Post-operative voiding dysfunction is common after sling placement and is assessed with a voiding trial (VT) before discharge. We hypothesized that an operating room (OR) initiated retrograde VT (OR-fill) would decrease time to discharge compared with a post-anesthesia care unit (PACU) initiated retrograde VT (PACU-fill).
  
  
  METHODS
  This was a parallel non-blinded randomized trial, of women undergoing outpatient sling surgery at a university hospital. In the OR-fill group, fill was initiated after sling placement during cystoscopy by leaving fluid in the bladder. In the PACU-fill group, fill was initiated in the PACU. Pre-VT volumes were recorded and a PVR ≤ 100 mL defined a passed VT. The primary outcome was total PACU time, defined as arrival in PACU until discharge home.
  
  
  RESULTS
  Thirty women were assigned to the OR-fill group and 29 to the PACU-fill group. Time from PACU arrival to VT was shorter in the OR-fill group (41.5 [31.0, 69.3] min vs 69.0 [44.0, 107.0] min, p = 0.03), but total PACU time in the groups was similar (125.0 [90.5, 180.5] min vs 131.5 [93.5, 178.0] min, p = 0.76). Bladder volume before VT was greater in the OR-fill group (557.3 ± 187.3 mL vs 433.0 ± 171.2 mL, p = 0.01). VT pass rates of the two groups were not significantly different (OR-fill 16.7% vs PACU-fill 24.1%, p = 0.48).
  
  
  CONCLUSIONS
  OR-fill VT did not decrease total PACU time compared with PACU-fill VT. No overdistension was seen in either group; transient postoperative voiding dysfunction was common.
authors.affiliation: Carolinas HealthCare System, 2001 Vail Avenue, Suite 360, Charlotte, NC, 28207, USA. erinn.myers@carolinas.org.
authors.forename: Erinn M
authors.initials: EM
authors.lastname: Myers
authors.affiliation: Wake Forrest Baptist Medical Center, Winston Salem, NC, USA.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Matthews
authors.affiliation: WakeMed Health and Hospitals, Raleigh, NC, USA.
authors.forename: Andrea K
authors.initials: AK
authors.lastname: Crane
authors.affiliation: The University of North Carolina, Chapel Hill, NC, USA.
authors.forename: AnnaMarie
authors.initials: A
authors.lastname: Connolly
authors.affiliation: The University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Wu
authors.affiliation: The University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Geller
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D011997:Recovery Room / Q000706:statistics & numerical data*; D053825:Suburethral Slings; D014546:Urinary Catheterization / Q000379:methods*; D014549:Urinary Incontinence / Q000601:surgery*; D014554:Urination
keywords: Midurethral sling; Retrograde voiding trial