E-Posters-Post-Operative Acute Urinary Retention in Patients with Robotic-Assisted Laparoscopic Sacrocolpoperineopexy

Post-Operative Acute Urinary Retention in Patients with Robotic-Assisted Laparoscopic Sacrocolpoperineopexy - Michael Kee-Ming Shu, MD

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This study examines the impact of a robotic-assisted laparoscopic sacrocolpoperineopexy (SCPP) on patients undergoing a transobturator mid-urethral sling (TOT) procedure. The researchers aimed to evaluate the peri- and short-term postoperative outcomes of SCPP with TOT sling. The study is a retrospective case-control series conducted from January 2013 to January 2019.<br /><br />The results of the study indicate that patients who underwent the combined R-ASCPP and TOT sling procedure had a higher frequency and greater severity of acute urinary retention compared to those who had the TOT sling alone. The researchers propose that the additional neuropathic component from R-ASCPP pelvic dissection may contribute to the increased risk of urinary retention. Surgeons should be vigilant in monitoring patients with elevated post-void residual bladder volumes and should intervene early by using intermittent or indwelling catheterization.<br /><br />The study also compared patient demographics between the two groups and found no significant differences in age, body mass index (BMI), gravidity, parity, prior laparotomy, or prior hernia repair.<br /><br />The authors suggest that further research is needed to better understand, prevent, and treat the increased incidence of urinary retention in patients undergoing R-ASCPP with concomitant TOT sling. The proposed mechanisms for urinary retention include global autonomic disruption from extensive pelvic dissection, transection of pelvic splanchnic/autonomic nerves, and differences in surgical technique.<br /><br />Overall, this study highlights the potential complications associated with combining R-ASCPP and TOT sling procedures. Surgeons should carefully consider the risks and benefits of this combined approach and take appropriate measures to prevent and manage postoperative urinary retention.

Keywords

robotic-assisted laparoscopic sacrocolpoperineopexy

SCPP

transobturator mid-urethral sling

TOT

perioperative outcomes

postoperative outcomes

acute urinary retention

neuropathic component

post-void residual bladder volumes

patient demographics