Tension-free vaginal tape: poor intraoperative cough test as a predictor of postoperative urinary retention

Original Article

Abstract

The purpose of this study was to determine if the quality of the intraoperative cough test could help to predict which patient would fail the post void residual test (PVR) immediately after a tension-free vaginal tape (TVT) procedure. Patients undergoing a TVT procedure only, under spinal or local anesthesia were enrolled. Patients were divided into two groups based on the outcome of the first postoperative PVR, failure group (FG) vs successful group (SG). Before adjusting the tape, patients underwent a standardized cough test. The quality of the cough test was determined to be either good or poor based on whether every cough produced a spurt of urine or not. Variables analyzed between the FG and SG were demographic and urodynamic data. Multivariate logistic regression analysis was used to calculate the adjusted odds ratios. Twenty-six (60.5%) women passed and 17 (39.5%) failed the initial postoperative PVR evaluation. There was a 4.89-fold greater odds of failing the postoperative PVR for women 65 and older compared to younger women (OR 4.89, 95% CI [1.07–26.45]). In addition, there was an 8.63-fold greater odds of failing postoperative PVR for patients with poor quality cough test (OR 8.63, 95% CI [1.54–54.66]). However, multivariate logistic regression analysis revealed that poor quality cough test was the only significant predictor for failing a postoperative PVR (OR 6.83, 95% CI [1.39–33.49], P = 0.018). A poor quality intraoperative cough test at the time of TVT procedure is a predictor of immediate postoperative urinary retention.

Keywords

TVT Urinary retention Cough test 

References

  1. 1.
    Cetinel B, Demirkesen O (2005) Risk factors influencing the complication rates of tension-free vaginal tape-type procedures. Curr Opin Obstet Gynecol 17(5):530–534PubMedCrossRefGoogle Scholar
  2. 2.
    Wang KH, Neimark M, Davila GW (2005) Voiding dysfunction following TVT procedure. Int Urogynecol J Pelvic Floor Dysfunct 13(6):353–357 (discussion 358)CrossRefGoogle Scholar
  3. 3.
    Mishra VC, Mishra N, Karim OM, Motiwala HG (2005) Voiding dysfunction after tension-free vaginal tape: a conservative approach is often successful. Int Urogynecol J Pelvic Floor Dysfunct 16(3):210–214 (discussion 214)PubMedCrossRefGoogle Scholar
  4. 4.
    Minassian VA, Al-Badr A, Drutz HP, Lovatsis D (2004) Tension-free vaginal tape, Burch, and slings: are there predictors for early postoperative voiding dysfunction? Int Urogynecol J Pelvic Floor Dysfunct 15(3):183–187PubMedCrossRefGoogle Scholar
  5. 5.
    Klutke C, Siegel S, Carlin B, Paszkiewicz E, Kirkemo A, Klutke J (2001) Urinary retention after tension-free vaginal tape procedure: incidence and treatment. Urology 58(5):697–701PubMedCrossRefGoogle Scholar
  6. 6.
    Hong B, Park S, Kim HS, Choo MS (2003) Factors predictive of urinary retention after a tension-free vaginal tape procedure for female stress urinary incontinence. J Urol 170(3):852–856PubMedCrossRefGoogle Scholar
  7. 7.
    Murphy M, Culligan PJ, Arce CM, Graham CA, Blackwell L, Heit MH (2005) Is the cough–stress test necessary when placing the tension-free vaginal tape? Obstet Gynecol 105(2):319–324PubMedGoogle Scholar
  8. 8.
    Ulmsten U, Henriksson L, Johnson P, Varhos G (1996) An ambulatory surgical procedure under local anesthesia for the treatment of female urinary incontinence. Int Urogynecol J 7:81–85 (discussion 85–86)CrossRefGoogle Scholar

Copyright information

© International Urogynecology Journal 2007

Authors and Affiliations

  1. 1.Department of Obstetrics and Gynecology (D-50), Jackson Memorial HospitalUniversity of Miami, Miller School of MedicineMiamiUSA

Personalised recommendations