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Comparative Study
. 2019 Feb;30(2):301-305.
doi: 10.1007/s00192-018-3638-y. Epub 2018 Mar 29.

Comparing postoperative voiding dysfunction after mid-urethral sling using either a Babcock or Kelly clamp tensioning technique

Olivia H Chang  1   2 , Michele R Hacker  1   2 , Peter L Rosenblatt  2   3 , Dayna Neo  1 , Emily Von Bargen  2   3 , Iman Berrahou  2 , Amy Le  2 , Roger Lefevre  1   2 , Lekha S Hota  4   5
Affiliations
Comparative Study

Comparing postoperative voiding dysfunction after mid-urethral sling using either a Babcock or Kelly clamp tensioning technique

Olivia H Chang et al. Int Urogynecol J. 2019 Feb.

Abstract

Introduction and hypothesis: The objective was to compare postoperative urinary retention using the Babcock and Kelly clamps for retropubic midurethral sling (RPS) tensioning.

Methods: This was a retrospective cohort of isolated RPS procedures from December 2010 through April 2016 by five fellowship-trained surgeons at two institutions. Slings were tensioned with a Babcock clamp by grasping a 3-mm midline fold of mesh (RPS-B) or a Kelly clamp as a spacer between the sling and suburethral tissue (RPS-K). Assessment of urinary retention included the primary outcome of postoperative catheterization and several secondary outcomes, including discharge home with a catheter, within 1 year of surgery. Analysis of covariance was used to compute the mean difference in duration of catheterization and log-binomial regression was used to calculate risk ratios (RR) and 95% confidence intervals (CI).

Results: We included 240 patients. The RPS-B group had a lower body mass index and was more likely to be menopausal, have had pelvic organ prolapse surgery, and have a lower maximum urethral closure pressure than the RPS-K group. The mean duration of catheterization was similar, as demonstrated by the crude (0.21 days [-0.30-0.71]) and BMI-adjusted (0.07 days [-0.41-0.55]) mean difference in duration of catheterization. The incidence of postoperative OAB symptoms was comparable between the groups (BMI-adjusted RR: 0.95 (0.80-1.1)), and the incidence of revision did not differ (p = 0.7).

Conclusions: The Babcock and Kelly clamp tensioning techniques appear comparable, with a low incidence of prolonged postoperative catheterization. Most catheters were removed on the day of the surgery. It is reasonable to tension retropubic midurethral slings with either method.

Keywords: Retropubic midurethral sling; Sling revision; Sling tensioning; Urinary retention.

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Conflict of interest statement

Conflicts of interest For the remaining authors no conflicts of interest were declared.

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