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Preoperative Valsalva voiding increases the risk of urinary retention after midurethral sling placement

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Abstract

Introduction and hypothesis

A subset of neurologically normal females void by efficient Valsalva, not detrusor contraction. We determined the incidence of urinary retention following midurethral sling (MUS) placement in women that void by detrusor contraction versus Valsalva.

Methods

Review of patients undergoing MUS insertion between 2002 and 2009 for urodynamic stress incontinence was performed. Women with concomitant pelvic surgery, previous incontinence surgery, or preoperative incomplete bladder emptying were excluded. Patients were divided into two cohorts based on preoperative urodynamic findings—those that voided with a detrusor contraction >10 cm of water and those that voided by Valsalva.

Results

One hundred seven patients were available for analysis. The postoperative urinary retention rate was 22% and 5% in the Valsalva and non-Valsalva groups, respectively (p < 0.05). Mean retention duration was 3 weeks for each cohort (range 1–6).

Conclusions

Women voiding by Valsalva are at increased risk of urinary retention following MUS placement.

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Abbreviations

MUS:

Midurethral sling

SUI:

Stress urinary incontinence

PVR:

Postvoid residual

VLPP:

Valsalva leak point pressure

PdetQmax:

Voiding detrusor pressure at maximum urine flow

PTFE:

Polytetrafluoroethylene

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Authors and Affiliations

  1. Department of Urology, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI, 53226, USA

    Khanh N. Pham, Nicole Topp, Michael L. Guralnick & Robert Corey O’Connor

  2. Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI, USA

    Sumana Koduri & Julianne R. Newcomer

Authors
  1. Khanh N. Pham
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  2. Nicole Topp
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  3. Michael L. Guralnick
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  4. Sumana Koduri
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  5. Julianne R. Newcomer
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  6. Robert Corey O’Connor
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Corresponding author

Correspondence to Robert Corey O’Connor.

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Pham, K.N., Topp, N., Guralnick, M.L. et al. Preoperative Valsalva voiding increases the risk of urinary retention after midurethral sling placement. Int Urogynecol J 21, 1243–1246 (2010). https://doi.org/10.1007/s00192-010-1177-2

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  • DOI: https://doi.org/10.1007/s00192-010-1177-2

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