Duration of Catheterization After Retropubic Midurethral Sling. Issue 5 (September 2019)

• Record Type: Journal Article
• Authors: Geynisman-Tan, Julia; Dave-Heliker, Bhumy; Bochenska, Katarzyna; Collins, Sarah; Lewicky-Gaupp, Christina; Mueller, Margaret; Kenton, Kimberly
• Is Part Of: Female pelvic medicine & reconstructive surgery. Volume 25:Issue 5(2019)
• Publication Date: 2019-09
• Subjects: midurethral sling -- incontinence -- urinary retention -- catheterization; Pelvis -- Diseases -- Periodicals; Pelvis -- Surgery -- Periodicals; Genital Diseases, Female -- surgery -- Periodicals; Urologic Diseases -- surgery -- Periodicals; Colonic Diseases -- surgery -- Periodicals; Rectal Diseases -- surgery -- Periodicals; Surgical Procedures, Operative -- methods -- Periodicals; 616.6
• DOI: 10.1097/SPV.0000000000000569
• Languages: English
• ISSNs: 2151-8378

Abstract

Abstract : Objective: The objective of this study was to describe the expected duration of self-catheterization in women discharged home performing intermittent self-catheterization (ISC) after retropubic midurethral sling (RMUS). Methods: We conducted a retrospective cohort analysis of women who underwent an isolated RMUS by 3 providers between 2009 and 2014 at a single institution. A 300 mL retrograde-fill voiding trial (VT) was performed before discharge. Those who failed their VT (postvoid residual [PVR] >1/3 total bladder volume [TBV]) and could perform ISC are included in this analysis. Subjects were categorized into mild retention (PVR >1/3 and <2/3 the TBV) or severe retention (PVR ≥2/3 the TBV). Patients could discontinue ISC after achieving 2 consecutive PVR volumes of less than 75 mL. Duration of catheterization was determined in days. Results: Two hundred women underwent isolated RMUS. Forty-seven (23.5%) failed their VT of whom 39 (included in this analysis) could perform ISC and had complete data. Subjects had a mean ± SD age of 49 ± 11 years. The median (interquartile range) PVR volume postoperatively was 250 (190–325) mL. Median (interquartile range) days of postoperative ISC for the cohort was 2 (1–4); 37.5% were catheterized for 1 day, 32.5% for 2 days, 2.5% for 3 days, and 27.5% for more than 3 days. Seventeen (39.5%) met the criteria for mild retention and 26 (60.5%) met the criteria for severe retention. There was no difference in the postoperative catheterization days between the mild and severe retention groups ( P = 0.16). Conclusions: Urinary retention will resolve within 2 days in the majority (73%) of women discharged performing ISC after RMUS.