A Prospective Evaluation of the Efficiency of Early Postoperative Bladder Emptying After the Stamey Procedure or Pubovaginal Sling for Stress Urinary Incontinence

Brady, Ciaran; Ahmed, I.; Drumm, John; Flood, Hugh D.

doi:10.1097/00005392-200105000-00044

Cited by 2 publications

(3 citation statements)

References 20 publications

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“…Moreover, in a study by Wang and Chen [14], nearly 45% of patients were unable to leak urine during a cough test in the dorsal lithotomy position. As there is no exact method of determining how much tension to put on the sling during surgery, the surgeon must rely chiefly on experience to make the judgement [3,4]. However, we found that patients with ISD were unlikely to achieve early efficient emptying and thus would not be suitable for discharge as day‐cases.…”

Section: Discussionmentioning

confidence: 96%

“…The EE was calculated as VV/(VV + PVR) × 100. Efficient emptying was defined as an EE of ≥ 75%[3]. Patients were considered suitable for discharge from hospital when emptying efficiently or when they could use CISC confidently with adequate pain control and had no significant complications.…”

Section: Methodsmentioning

confidence: 99%

“…The apparent cost‐effectiveness of day surgery makes this an attractive form of treatment to purchasers of healthcare. Modifications in sling techniques have resulted in broader indications [3], reduced morbidity and a shorter hospital stay [4]. Autologous rectus fascia remains the ‘gold standard’ sling material for the surgical treatment of SUI [5].…”

Section: Introductionmentioning

confidence: 99%

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Day‐case sling surgery for stress urinary incontinence: feasibility and safety

et al. 2005

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time required to achieve an EE of ≥ 75%, a visual analogue scale pain score, perioperative complications, and short-term cure rate of SUI. Patients were considered suitable for discharge from hospital when the EE was ≥ 75% or when they were self-catheterizing confidently with adequate pain control and no significant complication. All patients were followed for 6 months. RESULTSThe median EE at 10 h was 61%; 16 patients (40%) achieved efficient emptying and were suitable for discharge 10 h after surgery. The median intervals to the first three spontaneous voids were 7, 10 and 17 h, and the median EEs for the first three voids 46%, 61% and 75%. The median visual analogue scale pain score was 3.5. Patients with intrinsic sphincter deficiency (ISD) were significantly less likely to achieve efficient emptying at 10 h (39% vs 70%). Overall SUI was cured or improved in 90% of patients at the 6-month follow-up. CONCLUSIONSIn the present study only 40% of patients were suitable for day-case sling surgery. Early bladder emptying inefficiency was the main limiting factor. Exclusion of patients with ISD and possibly decreasing the EE threshold to 50% would improve the discharge rate. The short-term results of this PVS are similar to those obtained with the autologous fascial sling. KEYWORDSstress urinary incontinence, minimally invasive surgery, day-case surgery, pubovaginal sling OBJECTIVETo prospectively assess the feasibility for discharge 10 h after a porcine dermal pubovaginal sling procedure (PVS), to examine the surgical factors (postoperative complications) affecting discharge, and to measure the short-term cure rate for stress urinary incontinence (SUI).

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Section: Discussionmentioning

confidence: 96%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Day‐case sling surgery for stress urinary incontinence: feasibility and safety

et al. 2005

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A magnetic resonance imaging‐based study of retropubic haematoma after sling procedures: preliminary findings

Giri¹,

Wallis

Drumm³

et al. 2005

BJU International

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OBJECTIVE To determine, using magnetic resonance imaging (MRI), the incidence of retropubic haematoma and any associated clinically significant effects after a xenograft (porcine dermis) sling (XS) or the tension‐free vaginal tape (TVT) procedure. PATIENTS AND METHODS Between October 2003 and March 2004, 24 consecutive patients presenting with stress urinary incontinence (SUI) were enrolled in this prospective study; 12 each underwent an XS or TVT procedure. A vaginal balloon pack was used for only 3 h after XS and not after TVT. All patients had pelvic MRI 6–8 h after surgery. The primary outcome measure was the incidence and distribution of retropubic haematoma after each sling technique. Secondary outcome measures included the interval to the first three spontaneous voids, the bladder emptying efficiency of the first three voids, a visual analogue scale pain score at 24 h after surgery, and the short‐term (6‐month) cure rate for SUI. RESULTS Overall, six (25%) patients (four XS and two TVT) developed a retropubic haematoma. Most commonly, they spread along the right paravesico‐urethral space between the right half of the levator ani and the bladder neck. Patients with large haematomas took significantly longer to void (median 14.5 vs 6.0 h, P = 0.048). There was no difference in pain score in patients with or with no haematoma. None of the patients had clinically detectable haematomas in the suprapubic wound. All six patients with haematomas were cured or improved at the 6‐month follow‐up. CONCLUSIONS MRI is a useful noninvasive method for detecting retropubic haematomas soon after surgery. There was a surprisingly high incidence of retropubic haematomas, especially after the XS procedure. Retropubic haematomas may influence postoperative voiding efficiency.

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A Prospective Evaluation of the Efficiency of Early Postoperative Bladder Emptying After the Stamey Procedure or Pubovaginal Sling for Stress Urinary Incontinence

Cited by 2 publications

References 20 publications

Day‐case sling surgery for stress urinary incontinence: feasibility and safety

Day‐case sling surgery for stress urinary incontinence: feasibility and safety

A magnetic resonance imaging‐based study of retropubic haematoma after sling procedures: preliminary findings

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