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The efficacy of force of stream assessment for post-operative catheter management: a retrospective cohort study

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Abstract

Introduction and hypothesis

Postoperative urinary retention is common after urogynecologic procedures. Our objective is to determine the efficacy of force of stream (FOS) assessment without a visual analog scale for postoperative catheter management.

Methods

We conducted a retrospective cohort study of 110 women undergoing an inpatient gynecologic procedure. They were asked to subjectively assess FOS after surgery without a visual analog scale. If it was 50% or better than the usual preoperative void, they were discharged home without a catheter. If < 50%, the catheter was replaced and the patients were sent home and asked to follow up in 3 to 5 days for another void trial.

Results

Average age was 56.9 ± 10.2 years; 63.6% underwent surgery for pelvic organ prolapse, 23.6% underwent sling for urinary incontinence, and 12.7% underwent a combination of both. Force of stream was > 50% in 93.6% of the patients; 6.4% had force of stream < 50% and hence were discharged home with a Foley catheter. Only two patients (1.8%) were discharged without a Foley catheter and returned to the emergency department for signs of urinary retention. Sensitivity, specificity, positive and negative predictive values were 77.8%, 100%, 100% and 98.1%, respectively.

Conclusion

The subjective assessment of flow of stream is a reliable and safe method to assess postoperative voiding. Given it is less invasive than backfilling the bladder and easier than using a bladder scan, it should be the primary method to assess postoperative voiding.

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References

  1. Pelvic Organ Prolapse. Accessed October 22, 2020. https://www.acog.org/en/Clinical/ClinicalGuidance/PracticeBulletin/Articles/2019/11/PelvicOrganProlapse

  2. Smith FJ, Holman CDJ, Moorin RE, Tsokos N. Lifetime risk of undergoing surgery for pelvic organ prolapse. Obstet Gynecol. 2010;116(5):1096–100. https://doi.org/10.1097/AOG.0b013e3181f73729.

    Article  PubMed  Google Scholar 

  3. Smorgick N, DeLancey J, Patzkowsky K, Advincula A, Song A, As-Sanie S. Risk factors for postoperative urinary retention after laparoscopic and robotic hysterectomy for benign indications. Obstet Gynecol. 2012;120(3):581–6. https://doi.org/10.1097/AOG.0b013e3182638c3a.

    Article  PubMed  Google Scholar 

  4. Kesty K, Edenfield A, Castro D, et al. Subjective versus objective determination of bladder emptying following urogynecological surgery: “do you feel that you completely emptied your bladder?” Int Urogynecol J. 2020;31(9):1899–905. https://doi.org/10.1007/s00192-019-04216-0.

    Article  PubMed  Google Scholar 

  5. Dreijer B, Møller MH, Bartholdy J. Post-operative urinary retention in a general surgical population. Eur J Anaesthesiol. 2011;28(3):190–4. https://doi.org/10.1097/EJA.0b013e328341ac3b.

    Article  PubMed  Google Scholar 

  6. Barber MD, Kleeman S, Karram MM, et al. Transobturator tape compared with tension-free vaginal tape for the treatment of stress urinary incontinence: a randomized controlled trial. Obstet Gynecol. 2008;111(3):611–21. https://doi.org/10.1097/AOG.0b013e318162f22e.

    Article  PubMed  Google Scholar 

  7. Brackmann M, Carballo E, Uppal S, Torski J, Reynolds RK, McLean K. Implementation of a standardized voiding management protocol to reduce unnecessary re-catheterization - A quality improvement project. Gynecol Oncol. 2020;157(2):487–93. https://doi.org/10.1016/j.ygyno.2020.01.036.

    Article  PubMed  Google Scholar 

  8. Alas A, Hidalgo R, Espaillat L, Devakumar H, Davila GW, Hurtado E. Does spinal anesthesia lead to postoperative urinary retention in same-day urogynecology surgery? A retrospective review. Int Urogynecol J. 2019;30(8):1283–9. https://doi.org/10.1007/s00192-019-03893-1.

    Article  PubMed  Google Scholar 

  9. Ahmed MR, Sayed Ahmed WA, Atwa KA, Metwally L. Timing of urinary catheter removal after uncomplicated total abdominal hysterectomy: a prospective randomized trial. Eur J Obstet Gynecol Reprod Biol. 2014;176:60–3. https://doi.org/10.1016/j.ejogrb.2014.02.038.

    Article  PubMed  Google Scholar 

  10. Taylor DL, Sierra T, Duenas-Garcia OF, et al. Accuracy of bladder scanner for the assessment of postvoid residual volumes in women With pelvic organ prolapse. Female Pelvic Med Reconstr Surg. 2020;26(10):640–3. https://doi.org/10.1097/SPV.0000000000000645.

    Article  PubMed  Google Scholar 

  11. Dağdeviren H, Cengiz H, Helvacıoğlu Ç, Heydarova U, Kaya C, Ekin M. A comparison of normal and high post-void residual urine and urodynamic parameters in women with overactive bladder. Turk J Obstet Gynecol. 2017;14(4):210–3. https://doi.org/10.4274/tjod.84666.

    Article  PubMed  PubMed Central  Google Scholar 

  12. LaGrone LN, Sadasivam V, Kushner AL, Groen RS. A review of training opportunities for ultrasonography in low and middle income countries. Trop Med Int Health. 2012;17(7):808–19. https://doi.org/10.1111/j.1365-3156.2012.03014.x.

    Article  PubMed  Google Scholar 

  13. Tunitsky-Bitton E, Murphy A, Barber MD, Goldman HB, Vasavada S, Jelovsek JE. Assessment of voiding after sling: a randomized trial of 2 methods of postoperative catheter management after midurethral sling surgery for stress urinary incontinence in women. Am J Obstet Gynecol. 2015;212(5):597.e1-9. https://doi.org/10.1016/j.ajog.2014.11.033.

    Article  Google Scholar 

  14. Williams KS, Pilkinton ML, Shalom DF, Winkler HA. A randomized controlled trial comparing two voiding trials after midurethral sling with or without colporrhaphy. Int Urogynecol J. 2019;30(8):1247–52. https://doi.org/10.1007/s00192-018-3783-3.

    Article  PubMed  Google Scholar 

  15. Prevention of Infection After Gynecologic Procedures. Accessed November 4, 2020. https://www.acog.org/en/Clinical/ClinicalGuidance/PracticeBulletin/Articles/2018/06/PreventionofInfectionAfterGynecologicProcedures

  16. Lo T-S, Shailaja N, Hsieh W-C, Uy-Patrimonio MC, Yusoff FM, Ibrahim R. Predictors of voiding dysfunction following extensive vaginal pelvic reconstructive surgery. Int Urogynecol J. 2017;28(4):575–82. https://doi.org/10.1007/s00192-016-3144-z.

    Article  PubMed  Google Scholar 

  17. Carter-Brooks CM, Zyczynski HM, Moalli PA, Brodeur PG, Shepherd JP. Early catheter removal after pelvic floor reconstructive surgery: a randomized trial. Int Urogynecol J. 2018;29(8):1203–12. https://doi.org/10.1007/s00192-018-3641-3.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Baldini G, Bagry H, Aprikian A, Carli F. Postoperative urinary retention: anesthetic and perioperative considerations. Anesthesiology. 2009;110(5):1139–57. https://doi.org/10.1097/ALN.0b013e31819f7aea.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Lebanese American University Medical Center, Beirut, Lebanon

    Obey Albaini & Stephanie Farah

  2. Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Lebanese American University Medical Center LAUMCRH, P.O. Box 11-3288, Beirut, Lebanon

    Karl Jallad

Authors
  1. Obey Albaini
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  2. Stephanie Farah
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Contributions

OA Al Baini: design, data collection/analysis, interpretation, draft, revision.

SF Farah: design, data collection/analysis, interpretation, draft, revision.

KJ Jallad: analysis, draft, review; corresponding author.

They all agree to take responsibility and be accountable for the contents of the article and for the resolution of any related questions on this work. KJ is the corresponding author. He takes primary responsibility for communicating with the journal during all stages and responding to all queries.

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Correspondence to Obey Albaini, Stephanie Farah or Karl Jallad.

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Albaini, O., Farah, S. & Jallad, K. The efficacy of force of stream assessment for post-operative catheter management: a retrospective cohort study. Int Urogynecol J 33, 3291–3296 (2022). https://doi.org/10.1007/s00192-022-05096-7

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  • DOI: https://doi.org/10.1007/s00192-022-05096-7

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