Urinary retention after AdVance™ Sling: A multi-institutional retrospective study.

To identify risk factors for urinary retention following AdVance™ Sling placement using preoperative urodynamic studies to evaluate bladder contractility.

A multi-institutional retrospective review of patients who underwent an AdVance Sling for post-prostatectomy stress urinary incontinence from 2007 to 2019 was performed. Acute urinary retention (AUR) was defined as the complete inability to void or elevated post-void residual (PVR) leading to catheter placement or the initiation of intermittent catheterization at the first void trial postoperatively. Bladder contractility was evaluated based on preoperative urodynamics.

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 cmH2 O), 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; 95% confidence interval, 0.73-0.94; p = .003).

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. 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.

Neurourology and urodynamics. 2020 Dec 21 [Epub ahead of print]

Yu Zheng, Nicholas Major, Hailey Silverii, Goran Rac, Jennifer Rolef, Lauren Rittenberg, Arthur Mourtzinos, Matthew Moynihan, Ouida L Westney, Michael J Metro, Sender Herschorn, Jennifer Locke, Sarah Neu, Ross Rames, Lindsey Cox, Eric Rovner

Department of Urology, Medical University of South Carolina, Charleston, South Carolina, USA., Department of Urology, Lahey Health and Medical Center, Burlington, Massachusetts, USA., Department of Urology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA., Department of Urology, Temple University, Philadelphia, Pennsylvania, USA., Division of Urology, University of Toronto, Toronto, Ontario, USA.