Obstet Gynecol Sci.  2016 Mar;59(2):137-143. 10.5468/ogs.2016.59.2.137.

Risk factors for urinary retention after vaginal hysterectomy for pelvic organ prolapse

• Chong C
• Kim HS
• Suh DH
• Jee BC

• KMID: 2159009
• DOI: http://doi.org/10.5468/ogs.2016.59.2.137

Abstract

OBJECTIVE
To evaluate the risk factors for postoperative urinary retention in women who underwent vaginal hysterectomy for symptomatic pelvic organ prolapse.
METHODS
The medical records of 221 women who underwent vaginal hysterectomy with anterior and posterior colporrhapy were reviewed. Urinary retention after catheter removal was defined as the presence of at least one of the following three conditions: 1) failure of first voiding trial necessitating catheterization, 2) first residual urine volume after self-voiding ≥150 mL, and 3) Foley catheter re-insertion.
RESULTS
Urinary retention occurred in 60 women (27.1%). Multivariate and receiver operating characteristic curve analysis revealed that age (>63 years) and early postoperative day of catheter removal (day 1) was independent predictor for postoperative urinary retention. The incidence of urinary retention was significantly higher in women who removed indwelling catheter at day 1 (35.2%) than those at day 2 (12.0%, P=0.024), or day 3 (21.3%, P=0.044), but was similar to those at day 4 (25.0%, P=0.420). In women ≤63 years, urinary retention rate was not associated with the time of catheter removal after surgery; however, in women >63 years, the rate was significantly higher in day 1 removal group than day 2 to 4 removal group.
CONCLUSION
Age and postoperative day of catheter removal appear to be associated with postoperative urinary retention in women undergoing vaginal hysterectomy for pelvic organ prolapse. Keeping urinary catheter in situ at least for one day after vaginal prolapse surgery could be recommended, especially, in women older than 63 years.

Keyword

Hysterectomy, vaginal; Pelvic organ prolapse; Postoperative period; Urinary catheterization; Urinary retention

MeSH Terms

Catheterization
Catheters
Catheters, Indwelling
Female
Humans
Hysterectomy, Vaginal*
Incidence
Medical Records
Pelvic Organ Prolapse*
Postoperative Period
Risk Factors*
ROC Curve
Urinary Catheterization
Urinary Catheters
Urinary Retention*
Uterine Prolapse

Figure

• 

  Fig. 1 Receiver operating characteristics curve to demonstrate the predictability of age and postoperative day of catheter removal for occurrence of postoperative urinary retention after vaginal prolapse surgery. Area under the curve (95% confidence interval) of age>63 and postoperative day of catheter removal ≤1 was 0.585 (0.517 to 0.651) and 0.583 (0.515 to 0.649), respectively.

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