E-Posters-Risk Factors for Bladder Perforation at the Time of Retropubic Midurethral Sling Placement

Risk Factors for Bladder Perforation at the Time of Retropubic Midurethral Sling Placement - Viviana Casas-Puig, MD

Pdf Summary

A study conducted at the Cleveland Clinic aimed to determine the incidence and factors associated with bladder perforation during retropubic midurethral sling (R-MUS) placement, as well as the risk of postoperative adverse events in patients with bladder perforation. The study included women who underwent R-MUS placement for stress urinary incontinence between January 2010 and January 2017.<br /><br />Among the 1,187 patients who underwent R-MUS, the incidence of bladder perforation was 8%. Most perforations occurred in the dome of the bladder and were unilateral. Lower body mass index (BMI) and endometriosis were identified as independent risk factors for bladder perforation. However, patients with bladder perforation were not more likely to experience serious perioperative events.<br /><br />Perioperative data showed that patients with bladder perforation were more likely to be discharged home with a Foley catheter. The incidence of any postoperative adverse event was higher in patients with bladder perforation compared to those without perforation.<br /><br />On logistic regression analysis, lower BMI and endometriosis remained associated with bladder perforation.<br /><br />The findings of this study can be valuable in informing discussions regarding perioperative risks associated with R-MUS placement. Lower BMI and endometriosis should be considered as risk factors for bladder perforation in these procedures. Patients with bladder perforation may have a higher risk of postoperative adverse events, but further research is needed to establish causal relationships.

Keywords

Cleveland Clinic

bladder perforation

retropubic midurethral sling

R-MUS placement

incidence

factors associated

postoperative adverse events

risk factors

BMI

endometriosis