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International Urogynecology Journal
Published in: International Urogynecology Journal 4/2017

01-04-2017 | Original Article

Predictors of voiding dysfunction following extensive vaginal pelvic reconstructive surgery

Authors: Tsia-Shu Lo, Nagashu Shailaja, Wu-Chiao Hsieh, Ma. Clarissa Uy-Patrimonio, Faridah Mohd Yusoff, Rami Ibrahim

Published in: International Urogynecology Journal | Issue 4/2017

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Abstract

Introduction and Hypothesis

The objective of this study was to identify the predictors of postoperative voiding dysfunction in women following extensive vaginal pelvic reconstructive surgery.

Methods

We enrolled 1,425 women who had pelvic organ prolapse of POP-Q stage III or IV and had undergone vaginal pelvic reconstructive surgery with or without transvaginal mesh insertion from January 2006 to December 2014. All subjects were required to complete a 72-h voiding diary, and the IIQ-7, UDI-6, POPDI-6 and PISQ-12 questionnaires. Urodynamic study was performed preoperatively and postoperatively.

Results

Of the 1,425 women, 54 were excluded due to incomplete data, and 1,017 of the remaining 1,371 (74.2 %) had transvaginal mesh surgery and 247 (18 %) had concurrent midurethral sling insertion. Of 380 women (27.7 %) with preoperative voiding dysfunction, 37 (9.7 %) continued to have voiding dysfunction postoperatively. Of the remaining 991 women (72.3 %) with normal preoperative voiding function, 11 (1.1 %) developed de novo voiding dysfunction postoperatively. The overall incidence of postoperative voiding dysfunction was 3.5 % (48/1,371). Those with concurrent midurethral sling insertion were at higher risk of developing voiding dysfunction postoperatively (OR 3.12, 95 % CI 1.79 – 5.46, p < 0.001). Diabetes mellitus, preoperative detrusor pressure at maximal flow (Dmax) <10 cm H2O and postvoid residual volume ≥200 ml were significant risk factors for the development of postoperative voiding dysfunction (OR 3.07, 1.84 and 2.15, respectively; 95 % CI 1.69 – 5.60, 1.39 – 2.91 and 1.10 – 3.21, respectively).

Conclusions

Diabetes mellitus, concurrent midurethral sling insertion, preoperative Dmax <10 cm H2O and postvoid residual volume ≥200 ml in patients with advanced pelvic organ prolapse were risk factors for the development of postoperative voiding dysfunction after vaginal pelvic reconstructive surgery. Therefore, counseling is worthwhile before considering vaginal pelvic reconstructive surgery.
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Metadata
Title
Predictors of voiding dysfunction following extensive vaginal pelvic reconstructive surgery
Authors
Tsia-Shu Lo
Nagashu Shailaja
Wu-Chiao Hsieh
Ma. Clarissa Uy-Patrimonio
Faridah Mohd Yusoff
Rami Ibrahim
Publication date
01-04-2017
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 4/2017
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-016-3144-z

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