USA: A longer duration of catheterization after AdVance Sling placement may reduce acute urinary retention (AUR) occurrence, finds a recent study in the journal Neurourology and Urodynamics.
According to the study, after the surgery, chronic urinary retention is uncommon and acute retention is generally self-limiting. Neither urodynamic nor demographic factors were predictive of AR. Patients who developed AUR were more likely to have heir void trials within 2 days following the placement of AdVance Sling versus longer initial catheterization periods.
Eric Rovner, Medical University of South Carolina, Charleston, South Carolina, USA, and colleagues aimed to identify risk factors for urinary retention following AdVance Sling placement using preoperative urodynamic studies to evaluate bladder contractility.
For the purpose, the researchers performed a multi‐institutional retrospective review of patients who underwent AdVance Sling for post‐prostatectomy stress urinary incontinence from 2007 to 2019. AUR was defined as the complete inability to void or elevated post‐void residual (PVR) that lead to catheter placement or the initiation of intermittent catheterization at the first void trial postoperatively. Based on preoperative urodynamics, bladder contractility was evaluated.
Key findings of the study include:
Of the 391 patients in this study, 55 (14.1%) experienced AUR, and 6 patients (1.5%) had chronic urinary retention with a median follow‐up of 18.1 months.
In total, 303 patients (77.5%) underwent preoperative urodynamics, and there was no significant difference between average PdetQmax (26.4 vs. 27.4 cmH2O), Qmax (16.6 vs. 16.2 ml/s), PVR (19.9 vs. 28.1 ml), bladder contractility index (108 vs. 103) for patients with or without AUR following AdVance Sling.
Impaired bladder contractility preoperatively was not predictive of AUR.
Time to postoperative urethral catheter removal was predictive of AUR (odds ratio, 0.83).
"Chronic urinary retention after AdVance Sling placement is uncommon and acute retention is generally self‐limiting. No demographic or urodynamic factors were predictive of AUR," wrote the authors.
"Patients who developed AUR were more likely to have their void trials within 2 days following AdVance Sling placement versus longer initial catheterization periods, suggesting that a longer duration of postoperative catheterization may reduce the occurrence of AUR."
The study titled, "Urinary retention after AdVance™ Sling: A multi‐institutional retrospective study," is published in the journal Neurourology and Urodynamics.
DOI: https://onlinelibrary.wiley.com/doi/10.1002/nau.24591