Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun;40(5):1182-1191.
doi: 10.1002/nau.24676. Epub 2021 Apr 23.

Risk factors for urinary retention after urogynecologic surgery: A retrospective cohort study and prediction model

Bei Yuan Zhang  1 , Jeffrey Man Hay Wong  1 , Nicole A Koenig  1 , Terry Lee  2 , Roxana Geoffrion  1
Affiliations

Risk factors for urinary retention after urogynecologic surgery: A retrospective cohort study and prediction model

Bei Yuan Zhang et al. Neurourol Urodyn. 2021 Jun.

Abstract

Aims: Postoperative urinary retention (POUR) is a common complication of urogynecological surgery. Our study aimed to identify demographic and perioperative risk factors to construct a prediction model for POUR in urogynecology.

Methods: Our retrospective cohort study reviewed all patients undergoing pelvic reconstructive surgeries at our tertiary care center (Jan 1, 2013-May 1, 2019). Demographic, pre-, intra- and postoperative variables were collected from medical records. The primary outcome, POUR, was defined as (1) early POUR (E-POUR), failing initial trial of void or; (2) late POUR (L-POUR), requiring an indwelling catheter or intermittent catheterization on discharge. Risk factors were identified through univariate and multivariate logistic regression analyses. A clinical prediction model was constructed with the most significant and clinically relevant risk factors.

Results: In 501 women, 182 (36.3%) had E-POUR and 61 of these women (12.2% of the entire cohort) had L-POUR. Multivariate logistic regression revealed preoperative postvoid residual (PVR) over 200 ml (odds ratio [OR]: 3.17; p = 0.026), voiding dysfunction symptoms extracted from validated questionnaires (OR: 3.00; p = 0.030), and number of concomitant procedures (OR: 1.30 per procedure; p = 0.021) as significant predictors of E-POUR; preoperative PVR more than 200 ml (OR: 4.07; p = 0.011) and antiincontinence procedure with (OR: 3.34; p = 0.023) and without (OR: 2.64; p = 0.019) concomitant prolapse repair as significant predictors of L-POUR. A prediction model (area under the curve: 0.70) was developed for E-POUR.

Conclusions: Elevated preoperative PVR is the most significant risk factor for POUR. Alongside other risk factors, our prediction model for POUR can be used for patient counseling and surgical planning in urogynecologic surgery.

Keywords: postvoid residual; trial of void; urinary catheterization; urinary retention.

PubMed Disclaimer

Comment in

References

REFERENCES

    1. Geller EJ . Prevention and management of postoperative urinary retention after urogynecologic surgery. Int J Womens Health. 2014;6:829-838. https://doi.org/10.2147/IJWH.S55383
    1. Darrah DM , Griebling TL , Silverstein JH . Postoperative urinary retention. Anesthesiol Clin. 2009;27(3):465-484. https://doi.org/10.1016/j.anclin.2009.07.010
    1. Gagnon L-H , Tang S , Brennand E . Predictors of length of stay after urogynecological surgery at a tertiary referral center. Int Urogynecology J. 2017;28(2):267-273. https://doi.org/10.1007/s00192-016-3124-3
    1. Baldini G , Carli F . Postoperative urinary retention. Anesthesiology. 2009;110(5):1139-1157.
    1. Komesu YM , Olsen AL . Clinical predictors of urinary retention after pelvic reconstructive and stress urinary incontinence surgery. J Reprod Med. 2007;52(7):5.

Publication types

LinkOut - more resources