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Voiding trial outcome following pelvic floor repair without incontinence procedures

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Abstract

Introduction and hypothesis

Our aim was to identify predictors of postoperative voiding trial failure among patients who had a pelvic floor repair without a concurrent incontinence procedure in order to identify low-risk patients in whom postoperative voiding trials may be modified.

Methods

We conducted a retrospective cohort study of women who underwent pelvic floor repair without concurrent incontinence procedures at two institutions from 1 November 2011 through 13 October 2013 after abstracting demographic and clinical data from medical records. The primary outcome was postoperative retrograde voiding trial failure. We used modified Poisson regression to calculate the risk ratio (RR) and 95 % confidence interval (CI).

Results

Of the 371 women who met eligibility criteria, 294 (79.2 %) had complete data on the variables of interest. Forty nine (16.7 %) failed the trial, and those women were less likely to be white (p = 0.04), more likely to have had an anterior colporrhaphy (p = 0.001), and more likely to have had a preoperative postvoid residual (PVR) ≥150 ml (p = 0.001). After adjusting for race, women were more likely to fail their voiding trial if they had a preoperative PVR of ≥150 ml (RR: 1.9; 95 % CI: 1.1–3.2); institution also was associated with voiding trial failure (RR: 3.0; 95 % CI: 1.6–5.4).

Conclusions

Among our cohort, postoperative voiding trial failure was associated with a PVR of ≥150 ml and institution at which the surgery was performed.

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Acknowledgments

We would like to thank Dr. Eman Elkadry for helpful comments on this manuscript. This work was conducted with support from Harvard Catalyst | The Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health Award UL1 TR001102), and financial contributions from Harvard University and its affiliated academic healthcare centers.

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    Authors and Affiliations

    1. Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

      Sara Won, Miriam J. Haviland, Michele R. Hacker, Janet Li & Roger Lefevre

    2. Harvard Medical School, Boston, MA, USA

      Rui Wang, Sara Won, Emily Von Bargen, Michele R. Hacker, Janet Li & Roger Lefevre

    3. Boston Urogynecologic Associates, Mount Auburn Hospital, Harvard Medical School, Cambridge, MA, USA

      Emily Von Bargen

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    1. Rui Wang
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    2. Sara Won
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    3. Miriam J. Haviland
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    5. Michele R. Hacker
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    6. Janet Li
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    Correspondence to Roger Lefevre.

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    Rui Wang and Sara Won contributed equally to this work.

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    Wang, R., Won, S., Haviland, M.J. et al. Voiding trial outcome following pelvic floor repair without incontinence procedures. Int Urogynecol J 27, 1215–1220 (2016). https://doi.org/10.1007/s00192-016-2975-y

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    • DOI: https://doi.org/10.1007/s00192-016-2975-y

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