Transient urinary retention occurs frequently after pelvic organ prolapse surgery. While the prevalence of postoperative urinary retention has been reported for reconstructive procedures, a paucity of data exists for colpocleisis. The objectives of this retrospective cohort study were to identify risk factors for transient urinary retention after colpocleisis and to determine the rate of its occurrence.
A retrospective chart review was performed for patients undergoing colpocleisis from January 2015 to December 2019 in a high-volume urogynecology practice. Patients were excluded if they required prolonged catheterization postoperatively because of a surgical complication or used a catheter before surgery, or if a suprapubic catheter was placed during surgery. Potential patient and procedural risk factors were analyzed. Transient urinary retention was diagnosed if patients failed their postoperative voiding trial and went home with a catheter.
A total of 172 patients met the inclusion criteria. The incidence of transient postoperative urinary retention was 55%, with rates of 36.7% with LeFort colpocleisis, 51.5% with posthysterectomy colpocleisis, and 64.9% with colpocleisis with concomitant hysterectomy. Logistic regression revealed an increased risk of postoperative urinary retention if hysterectomy was performed at the time of colpocleisis (odds ratio, 2.9; confidence interval, 1.23-6.84; P = 0.015). Patient age, prolapse severity, preoperative postvoid residual volume, and concomitant anti-incontinence procedure were not associated with transient postoperative urinary retention.
Transient urinary retention occurs in more than half of patients after colpocleisis. Patients undergoing concomitant hysterectomy have the highest risk of postoperative urinary retention. Surgeons can use this information both for counseling and management decisions for individual patients.
Female pelvic medicine & reconstructive surgery. 2021 Jul 13 [Epub ahead of print]
Angela DiCarlo-Meacham, Katherine Dengler, Eva Welch, Sara Hamade, Nicolette Horbach, Jeffrey Welgoss, Donna Mazloomdoost, Michael Sheridan, Walter von Pechmann
From the Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Walter Reed National Military Medical Center, Bethesda, MD Department of Obstetrics and Gynecology, INOVA Fairfax Medical Campus, Falls Church Mid-Atlantic Urogynecology and Pelvic Surgery, Annandale, VA.