Effect of Preoperative Low Maximal Flow Rate on Postoperative Voiding Trials after the Midurethral Sling Procedure in Women with Stress Urinary Incontinence

Chae, Ji Yun; Bae, Jae Hyun; Lee, Jeong G.; Park, Hong S.; Moon, Du Geon; Oh, Mi Mi

doi:10.1111/luts.12170

Cited by 3 publications

(9 citation statements)

References 33 publications

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“…There are numerous studies reporting on the use of preoperative urodynamics to predict postoperative voiding dysfunction and urinary retention 72–76,122,123 . Most studies report that no single urodynamic voiding parameter accurately predicts POUR.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Urinary Retention

McDermott

Tunitsky-Bitton

Dueñas-García

et al. 2023

UROGC

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This clinical consensus statement on the management of postoperative (<6 weeks) urinary retention (POUR) reflects statements drafted by content experts from the American Urogynecologic Society's POUR writing group. The writing group used a modified Delphi process to evaluate statements developed from a structured literature search and assessed for consensus. After the definition of POUR was established, a total of 37 statements were assessed in the following 6 categories:(1) incidence of POUR, (2) medications, (3) patient factors, (4) surgical factors, (5) urodynamic testing, and (6) voiding trials. Of the 37 original statements, 34 reached consensus and 3 were omitted.

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Section: Discussionmentioning

confidence: 99%

Postoperative Urinary Retention

McDermott

Tunitsky-Bitton

Dueñas-García

et al. 2023

UROGC

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“…Stress urinary incontinence (SUI) (involuntary leakage of urine on exertion, laughing, coughing, and sneezing) is the most common debilitating social problem, which leads to a reduction in their quality of life [1,2]. It is associated with significant sexual dysfunction, loss of independence, physical morbidity, and a reduction in psychological well-being, with consequent decreased participation in domestic and social activities [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…Over the years, the mid-urethral sling (MUS) operation has become the most common female SUI treatment owing to its long-term high success rate, safety, easiness and low complication rates is grade A for surgical treatment of MUS as the latest technical advances, which are more effective and simpler than previous anti-incontinence operations [1,4]. European Association of Urology (EAU) guidelines recently recommended Tension-free midurethral sling is grade A for surgical treatment of MUS as the latest technical advances, which are more effective and simpler than previous antiincontinence operations [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Two main methods are used to carry out this operation, either by placing a tape behind the pubic bone through groin ('transobturator'), or through the abdomen ('retropubic') [4]. Although, several studies have reported the success rate of MUS surgery for SUI, some patients experience complications following this operation such as de novo urgency or mesh erosion, recurrent SUI and postoperative voiding dysfunction (PVD) [1,2,7].…”

Section: Introductionmentioning

confidence: 99%

“…Although VD is a well-recognized complication, the methods for and definitions of evaluating VD are still controversial in the literature because the symptoms and incidence of VD is variable. However, most of literature represented the association of any subjective complaint of abnormal voiding such as: decreased flow rate, hesitancy, Intermittency, spraying (splitting), incomplete bladder emptying, straining to void and need to immediately re-void and objective significant postvoid residual (PVR), ouroflowmetry changes [1,2]. In general, International Urogynaecological association and the International Continence Society defined VD as "incomplete micturition and /or abnormally slow based on urodynamic and symptoms investigations" [9].…”

Section: Introductionmentioning

confidence: 99%

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Patient satisfaction and objective outcome assessment following mid-urethral sling procedures in women with stress urinary incontinence: A prospective study

Ghanbari

Sany

Hajhashemi

et al. 2019

Preprint

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Background Mid-urethral sling (MUS) operations are currently a recognized as the most popular and effective procedures for the surgical treatment of stress urinary incontinence (SUI) among women population. However, data reporting a long-term outcome is still equivocal, and thus, the data available are limited. This study aims to examine the efficacy of MUS operations after implantation for the treatment of women SUI during 3-years follow up. Method A prospective study was conducted in referral centers in the Tehran University of Medical Science, Emam Khomeini Hospital, Iran. 105 patients with urodynamically proven pure SUI or mix incontinence treated by MUS surgeries (TOT-TVT) were included. Patients with history of prior anti-incontinence surgery and abdominal radical pelvic surgery were excluded. Data regarding objective cure rates, subjective outcomes (Urogenital Distress Inventory Questionnaire–Short Form, Surgical Satisfaction Questionnaire) were collected during follow-up. We analyzed the preoperative parameters by univariate and multivariate analysis was conducted to investigate outcomes. Results One hundred five women had MUS implantation. At 4-years follow-up, 101 women (95%) were available for the assessment. We find evidence of significant improvement in urinary symptoms, objective cure rates and patient satisfaction after operation. At 3-years follow up, 80 of 101 women (82.17%) indicated themselves cured. Similarly, at 3-years evaluation, 83 of 101 women (82.17%) were satisfied or very satisfied, not showing visible urine leakage; and a state that did not need interval surgery. The multivariate analysis of the preoperative parameters revealed that age, VD, absences of urgency symptoms were the parameters related independently to the surgical success and patient’s satisfaction and Qmax was well associated with postoperative voiding dysfunction (PVD). Conclusion The 4-years findings of this study suggest that MUS surgeries are an effective procedures for the treatment of SUI.

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Active Compared With Passive Voiding Trials After Midurethral Sling Surgery

Drangsholt,

Lleras,

Kindler

et al. 2024

Obstetrics &Amp; Gynecology

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OBJECTIVE: To compare active with passive voiding trials on the rate of passing a trial of void and discharge rates with catheter in women who have undergone midurethral sling for treatment of stress urinary incontinence (SUI). DATA SOURCES: MEDLINE, EMBASE, and ClinicalTrials.gov were searched through February 24, 2023. METHODS OF STUDY SELECTION: Our population included women undergoing midurethral sling, with or without anterior or posterior repair, for treatment of SUI. Our two primary outcomes were rate of passing voiding trial and rate of discharge with a catheter. Our secondary outcome was the rate of delayed postoperative urinary retention, when a patient initially passes a trial of void but then subsequently presents in retention. TABULATION, INTEGRATION, AND RESULTS: Abstracts were doubly screened; full-text articles were doubly screened; and accepted articles were doubly extracted. In single-arm studies evaluating either passive or active voiding trial, random-effects meta-analyses of pooled proportions were used to assess outcomes. Of 3,033 abstracts screened, 238 full-text articles were assessed, and 26 met inclusion criteria. Ten studies including 1,370 patients reported active trial of void. Sixteen studies including 3,643 patients reported passive trial of void. We included five randomized controlled trials, five comparative retrospective studies, five prospective single group studies, and 11 retrospective single group studies. Five of the studies included patients with a concomitant anterior or posterior colporrhaphy. On proportional meta-analysis, the active trial of void group was less likely to pass the voiding trial (81.0%, 95% CI, 0.76–0.87% vs 89.0%, 95% CI, 0.84–0.9%3, P=.029) with high heterogeneity (I 2=93.0%). Furthermore, there were more discharges with catheter in active trial of void compared with passive trial of void (19.0%, 95% CI, 0.14–0.24% vs 7.0%, 95% CI, 0.05–0.10%, P<.01). The rates of delayed postoperative urinary retention were low and not different between groups (0.6%, 95% CI, 0.00–0.02% vs 0.2%, 95% CI, 0.00–0.01%, P=.366) with low heterogeneity (I 2=0%). Sling revisions were statistically lower in the active trial of void group (0.5%, 95% CI, 0.00–0.01% vs 1.5%, 95% CI, 0.01–0.02%, P=.035) with low heterogeneity (I 2=10.4%). CONCLUSION: Passive trial of void had higher passing rates and lower discharge with catheter than active trial of void. Rates of most complications were low and similar between both groups, although passive trial of void had higher sling revisions. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42022341318.

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Effect of Preoperative Low Maximal Flow Rate on Postoperative Voiding Trials after the Midurethral Sling Procedure in Women with Stress Urinary Incontinence

Abstract: Our results suggest that women with preoperative low Qmax experienced no definite unfavorable voiding problem from the MUS procedure compared to those with normal voiding function. MUS procedure may be regarded as a safe and successful procedure in SUI women with low Qmax.

Cited by 3 publications

References 33 publications

Postoperative Urinary Retention

Postoperative Urinary Retention

Patient satisfaction and objective outcome assessment following mid-urethral sling procedures in women with stress urinary incontinence: A prospective study

Active Compared With Passive Voiding Trials After Midurethral Sling Surgery

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