Preoperative Bladder Bowel Dysfunction is the Most Important Predictive Factor for Postoperative Urinary Retention after Robot Assisted Laparoscopic Extravesical Ureteral Reimplantation: a Multi-center Study.

Introduction Postoperative acute urinary retention (pAUR) is a known occurrence after robot-assisted laparoscopic extravesical ureteral reimplantation (RALUR-EV). We hypothesized that the risk factor of pAUR after RALUR-EV might be similar to that of pAUR after open reimplantation. We aimed to perform a retrospective multi-institutional study to evaluate the risk factors for pAUR after RALUR-EV. Materials and Methods Perioperative data collected from two tertiary referral hospitals included demographics and perioperative variables such as bladder bowel dysfunction (BBD) status, vesicoureteral reflux (VUR) grade, and laterality. pAUR was defined as the need for urethral catheter replacement after removal of the initial postoperative catheter. Univariate and multivariate analyses were performed to identify risk factors for pAUR. Results A total of 117 patients with 174 renal units from the two hospitals were enrolled in this study. The median age at the time of surgery was 5 (0.3-19) years. Bilateral RALUR-EV was performed in 57 (48.7%) cases. pAUR rate was 3.4% in all patients and 7.0% in 57 patients with bilateral VUR. All 4 cases of pAUR occurred after bilateral surgery. Univariate analysis showed age (p = 0.037), weight (p = 0.039), height (p = 0.040), and bilaterality (p = 0.037) as risk factors of pAUR. In a multivariate analysis, BBD was the only significant risk factor of pAUR (p = 0.037). Conclusion Urinary retention after RALUR-EV occurred less frequently when compared to the previously reported open surgery series. pAUR was seen only in bilateral cases in our series. Preoperative history of BBD, but not male gender or length of surgical time, was the only risk factor of pAUR after RALUR-EV.

Journal of endourology. 2020 Aug 31 [Epub ahead of print]

Sang Hoon Song, Il-Hwan A Kim, Jae Hyeon Han, Kun Suk Kim, Esther J Kim, Kunj Raju Sheth, Jonathan A Gerber, Vinaya Bhatia, Minki Baek, Chester J Koh

Texas Children's Hospital, 3984, Division of Pediatric Urology, Department of Surgery, Houston, Texas, United States., Asan Medical Center, 65526, Department of Urology, Songpa-gu, Seoul, Korea (the Republic of); ., Asan Medical Center, 65526, Department of Urology, Songpa-gu, Seoul, Korea (the Republic of); ., Texas Children's Hospital, 3984, Urology, Houston, Texas, United States.