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International Urogynecology Journal

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01-08-2019 | Spinal Anesthesia | Original Article

Does spinal anesthesia lead to postoperative urinary retention in same-day urogynecology surgery? A retrospective review

Authors: Alexandriah Alas, Ryan Hidalgo, Luis Espaillat, Hemikaa Devakumar, G. Willy Davila, Eric Hurtado

Published in: International Urogynecology Journal | Issue 8/2019

Abstract

Introduction and hypothesis

Spinal anesthesia has been reported to be a risk factor for postoperative urinary retention (POUR) in various surgical specialties. We hypothesized that spinal anesthesia was a risk factor for POUR after outpatient vaginal surgery for pelvic organ prolapse (POP).

Methods

This was a retrospective review of an urogynecology database for all outpatient POP vaginal surgeries performed in 2014 to evaluate the risk of POUR after general versus spinal anesthesia. A standardized voiding trial was performed by backfilling the bladder with 300 ml of saline. A successful trial was achieved if the patient voided two-thirds of the total volume instilled, confirmed by bladder ultrasound. Our primary outcome was to compare POUR requiring discharge with a Foley catheter between spinal and general anesthesia. Multivariate logistic regression was performed for variables with significance at p < 0.1 at the bivariate level.

Results

A total of 177 procedures were included, 126 with general and 51 with spinal anesthesia. The overall POUR rate was 48.9%. Type of anesthesia was not a risk factor for POUR. Multivariate logistic regression demonstrated that age < 55 years (adjusted odds ratio [OR] 3.73; 95% confidence interval [CI], 1.31–11.7), diabetes (adjusted OR 4.18, 95% CI 1.04–21.67), and having a cystocele ≥ stage 2 (adjusted OR 4.23, 95% CI 1.89–10) were risk factors for developing POUR.

Conclusions

Acute urinary retention after outpatient vaginal pelvic floor surgery can vary by procedure, but overall is 48.9%. Spinal anesthesia does not contribute to POUR, but rates are higher in those women that are younger than 55 years of age, have a cystocele ≥ stage 2 preoperatively, and a history of diabetes.

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Title: Does spinal anesthesia lead to postoperative urinary retention in same-day urogynecology surgery? A retrospective review
Authors: Alexandriah Alas
Ryan Hidalgo
Luis Espaillat
Hemikaa Devakumar
G. Willy Davila
Eric Hurtado
Publication date: 01-08-2019
Publisher: Springer International Publishing
Keywords: Spinal Anesthesia
Cystocele
Cystocele
Vaginal Surgery
Published in: International Urogynecology Journal / Issue 8/2019
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-019-03893-1

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Does spinal anesthesia lead to postoperative urinary retention in same-day urogynecology surgery? A retrospective review

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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