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
Meta-Analysis
. 2023 Jul 7;12(1):115.
doi: 10.1186/s13643-023-02233-1.

Methods of postoperative void trial management after urogynecologic surgery: a systematic review and meta-analysis

Xue Dong #  1   2   3 , Wu Huang #  4 , Jinyang Niu  5 , Tingting Lei  6 , Xin Tan  7   8   9 , Tao Guo  10   11
Affiliations
Meta-Analysis

Methods of postoperative void trial management after urogynecologic surgery: a systematic review and meta-analysis

Xue Dong et al. Syst Rev. .

Abstract

Background: Voiding trials are used to identify women at risk for postoperative urinary retention while performing optimal voiding trial management with minimal burden to the patient and medical service team. We performed a systematic review and meta-analysis of postoperative void trials following urogynecologic surgery to investigate (1) the optimal postoperative void trial methodology and (2) the optimal criteria for assessing void trial.

Method: We searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and relevant reference lists of eligible articles from inception to April 2022. We identified any randomized controlled trials (RCTs) in English that studied void trials in patients undergoing urogynecologic surgery. Study selection (title/abstract and full text), data extraction, and risk of bias assessment were conducted by two independent reviewers. Extracted study outcomes included the following: the correct passing rate, time to discharge, discharge rate without a catheter after the initial void trial, postoperative urinary tract infection, and patient satisfaction.

Results: Void trial methodology included backfill-assisted and autofill studies (2 RCTs, n = 95). Backfill assistance was more likely to be successful than autofill (RR 2.12, 95% CI 1.29, 3.47, P = 0.00); however, no significant difference was found in the time to discharge (WMDs = - 29.11 min, 95% CI - 57.45, 1.23, P = 0.06). The criteria for passing void trial included subjective assessment of the urinary force of stream and objective assessment of the standard voiding trial (3 RCTs, n = 377). No significant differences were found in the correct passing rate (RR 0.97, 95% CI 0.93, 1.01, P = 0.14) or void trial failure rate (RR 0.78, 95% CI 0.52, 1.18, P = 0.24). Moreover, no significant differences were found in the complication rates or patient satisfaction between the two criteria.

Conclusion: Bladder backfilling was associated with a lower rate of catheter discharge after urogynecologic surgery. The subjective assessment of FOS is a reliable and safe method for assessing postoperative voiding because it is less invasive.

Systematic review registration: PROSPERO CRD42022313397.

Keywords: Force of stream (FOS); Standard voiding trial (SVT); Systematic review; Urogynecologic surgery; Void trial (VT).

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Risk of bias assessment, including graph (A) and summary (B)
Fig. 2
Fig. 2
Meta-analysis considering trials comparing VT methods (A successful VT, B time to discharge) and trials comparing criteria for passing VT (C correct passing, D discharge with a catheter, E UTI) according to the forest plot
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Wu JM, Matthews CA, Conover MM, Pate V, Jonsson Funk M. Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet Gynecol. 2014;123(6):1201–1206. doi: 10.1097/AOG.0000000000000286. - DOI - PMC - PubMed
    1. Smith FJ, Holman CD, Moorin RE, Tsokos N. Lifetime risk of undergoing surgery for pelvic organ prolapse. Obstet Gynecol. 2010;116(5):1096–1100. doi: 10.1097/AOG.0b013e3181f73729. - DOI - PubMed
    1. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ (Clin Res Ed) 2003;327(7414):557–560. doi: 10.1136/bmj.327.7414.557. - DOI - PMC - PubMed
    1. Braga A, Caccia G, Regusci L, Salvatore S, Papadia A, Serati M. Mid-urethral sling in a day surgery setting: is it possible? Int Urogynecol J. 2020;31(4):817–821. doi: 10.1007/s00192-019-04159-6. - DOI - PubMed
    1. Schachar JS, Ossin D, Plair AR, Hurtado EA, Parker-Autry C, Badlani G, Davila GW, Matthews CA. Optimal timing of a second postoperative voiding trial in women with incomplete bladder emptying after vaginal reconstructive surgery: a randomized trial. Am J Obstet Gynecol. 2020;223(2):260.e261–260.e269. doi: 10.1016/j.ajog.2020.06.001. - DOI - PubMed