Risk Factors Related to Immediate Urinary Retention after Tension-free Vaginal Tape Procedure

Park, Sung Chan; Hong, Bum Sik; Choo, Myung Soo

Abstract

PURPOSE: This study was performed to evaluate factors related to an immediate urinary retention, following the tension-free vaginal tape (TVT) procedure, which are embarrassing to both the patient and surgeon.
MATERIALS AND METHODS
The records of 375 women, with a follow-up of at least 6 months, among patients that underwent the TVT procedure, between May 1999 and May 2002, were retrospectively reviewed. Of the 375 patients, 32 (8.5%) developed a urinary retention (retention group) that required at least 3 days of intermittent catheterization following the procedure. Multiple parameters, with regard to the patients characteristics, symptoms, and urodynamic studies, were analyzed using univariate and multivariate regression analyses between the non-retention (n=343) and the retention (n=32) groups. All the patients, in both groups, answered the global satisfaction question.
RESULTS
Ninety percents of the patients (338/375) answered favorably toward the procedure on the global satisfaction question. The univariate analysis demonstrated that the patient's mean age, peak urinary flow rate, and parity, could predict the immediate urinary retention. However, in the multivariate analysis, the peak urinary flow rate was the only significant independent predictive factor (p=0.007). While 28 (87.5%) of the retention group regained normal voiding, with no specific procedure, 4 had to undergone releasing or cutting of the tape within 3 month of the surgery. The global satisfaction question showed a significant difference between the non-retention and retention groups (91.5% satisfaction versus 75% satisfaction, p=0.030).
CONCLUSIONS
An accurate measurement of the peak urinary flow rate could predict the women at risk of postoperative urinary retention and compromise the patient's global satisfaction after a highly curative TVT procedure.