E-Posters-Postoperative Urinary Retention after Anterior Trans-vaginal Mesh Repair

Postoperative Urinary Retention after Anterior Trans-vaginal Mesh Repair - Xiuli Sun

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This study aimed to investigate the incidence and risk factors of postoperative urinary retention (POUR) in patients who underwent anterior trans-vaginal mesh implantation for pelvic organ prolapse (POP). The data of 387 patients who underwent the procedure from January 2014 to December 2017 were retrospectively reviewed. The study found that increased gravidity, concomitant tension-free vaginal tape (TVT), and posterior colporrhaphy were associated with POUR. On the other hand, patients who received spinal-epidural anesthesia or concomitant hysterectomy were less likely to develop POUR. <br /><br />A total of 27.6% (107/387) of the patients developed POUR, including 5 patients who were lost to follow-up and were excluded from the calculation of the long-term POUR rate. Only one patient (0.3%) had prolonged POUR, requiring an indwelling catheter for 45 days. Two patients required surgical correction for POUR. The rest of the patients were treated with prolonged indwelling catheters or medication. <br /><br />The study also examined the management of POUR based on post-void residual volume (PVR). The majority of patients with POUR required catheterization, while some were treated with medication or underwent surgery. The voiding function of all patients eventually recovered well. <br /><br />In conclusion, this study found that increased gravidity, concomitant TVT, and posterior colporrhaphy were associated with the development of POUR in anterior trans-vaginal mesh implantation for POP. Conversely, spinal-epidural anesthesia and concomitant hysterectomy were found to be protective factors against POUR. These findings can guide the prevention and management of POUR in pelvic organ reconstructive surgeries.

Keywords

postoperative urinary retention

incidence

risk factors

anterior trans-vaginal mesh implantation

pelvic organ prolapse

gravidity

tension-free vaginal tape

posterior colporrhaphy

spinal-epidural anesthesia

concomitant hysterectomy