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. 2022 Jul;33(7):1999-2004.
doi: 10.1007/s00192-021-04992-8. Epub 2021 Sep 29.

Voiding function after sacrocolpopexy versus native tissue transvaginal repair for apical pelvic organ prolapse in an ERAS era: A retrospective cohort study

Amr Sherif El Haraki  1 , Jersey Burns  2 , Christopher L Crafton  1 , Candace Parker-Autry  1 , Catherine Ann Matthews  3   4
Affiliations

Voiding function after sacrocolpopexy versus native tissue transvaginal repair for apical pelvic organ prolapse in an ERAS era: A retrospective cohort study

Amr Sherif El Haraki et al. Int Urogynecol J. 2022 Jul.

Abstract

Objective: The objectives of this study were to compare time to return of voiding function and associated complications in women undergoing minimally invasive sacrocolpopexy (SCP) versus transvaginal native tissue repair in patients with same-day or early discharge.

Methods: This was a retrospective cohort study conducted at a tertiary care center. The electronic medical record system was queried for women who underwent native tissue vaginal repair or SCP for apical prolapse between March and December 2020 using CPT codes for sacrocolpopexy (57425), extraperitoneal (57282), and intraperitoneal colpopexy (57283). Voiding success was our primary outcome and was defined by a postvoid residual < 150 ml. Secondary outcomes included catheter days and urinary tract infections. The total number of participants was based on a power calculation using internal institutional rates. Participants were compared based on the surgical approach. A multivariate regression analysis was performed to assess for confounding factors.

Results: We included 134 women: 63 SCP and 71 native tissue. The failure rate of the first postoperative voiding trial was 34 vs. 11% (odds ratio: 4.91; 95% CI 1.96-12.3, p < 0.01) in the vaginal and SCP groups, respectively. Both groups had a similar success rate of a second voiding trial (100% in SCP group vs. 95.7% in the vaginal repair group, p = 1). The total number of days (3.108 vs. 1.603 days, p < 0.01) to return of bladder function, postoperative urinary tract infections (23.9 vs. 6.35%, p < 0.01) and emergency department visits (15.5 vs. 1.59%, p < 0.01) were all higher in the vaginal repair group.

Conclusions: Vaginal apical native tissue repair had a fivefold greater risk of acute postoperative urinary retention compared to sacrocolpopexy in addition to increased rates of post-operative urinary tract infection and emergency department visits for urinary tract concerns.

Keywords: ERAS; Native tissue repair; Sacrocolpopexy; Sacrospinous; Urinary retention; Uterosacral; Voiding function; Voiding trial.

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Conflict of interest statement

Catherine Matthews has grant support to institution from Boston Scientific Corporation and Neomedic; Catherine Matthews is a consultant to Boston Scientific Corporation and has received honoraria from Neomedic. All other authors have no conflicts to disclose.

Figures

Fig. 1
Fig. 1
Odds ratio of different variables as they relate to POUR
See this image and copyright information in PMC

References

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