Perioperative Anticholinergic Medications and Risk of Catheterization After Urogynecologic Surgery

Walter, Paige; Dieter, Alexis A.; Siddiqui, Nazema Y.; Weidner, Alison C.; Wu, Jennifer M.

doi:10.1097/spv.0000000000000075

Cited by 23 publications

(17 citation statements)

References 21 publications

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“…A separate study examining anticholinergic load in perioperative medications found that higher exposure to perioperative anticholinergic medications increased the risk of a failed postoperative VT following outpatient urogynecologic surgery. 36 ERAS protocols should be mindful of the perioperative anticholinergic load in patients undergoing benign gynecologic and urogynecologic surgeries in order to reduce the risk of postoperative voiding dysfunction.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of Randomized Trials Investigating Methods of Postoperative Void Trials Following Benign Gynecologic and Urogynecologic Surgeries

Dieter

Conklin²,

Willis-Gray

et al. 2021

Journal of Minimally Invasive Gynecology

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Section: Discussionmentioning

confidence: 99%

A Systematic Review of Randomized Trials Investigating Methods of Postoperative Void Trials Following Benign Gynecologic and Urogynecologic Surgeries

Dieter

Conklin²,

Willis-Gray

et al. 2021

Journal of Minimally Invasive Gynecology

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“…Walter et al examined the effect of multiple anti-cholinergic medications on patients undergoing prolapse or anti-incontinence procedures. (31)…”

Section: Discussionmentioning

confidence: 99%

Effect of Scopolamine Patch Use on Postoperative Voiding Function After Transobturator Slings

Dessie

Hacker

Apostolis

et al. 2016

Female Pelvic Medicine &Amp; Reconstructive Surgery

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Objectives The aim of this study was to determine whether the use of a pre-operative transdermal scopolamine patch for post-operative nausea and vomiting prophylaxis affects the success of a voiding trial after a transobturator tape sling procedure. Methods This study is a retrospective cohort study of adult women who underwent a transobturator tape sling procedure without concomitant procedures from February 1, 2009 through August 1, 2010. The exposed group included all eligible women who received a pre-operative transdermal scopolamine patch. For each exposed woman, we selected the next two consecutive eligible women who did not receive a transdermal scopolamine patch to be included in the unexposed group. The primary outcome was post-operative voiding trial failure. Results We identified 35 women who met eligibility criteria and used a pre-operative transdermal scopolamine patch, and included 70 women who did not use a pre-operative transdermal scopolamine. A significantly higher proportion of women in the transdermal scopolamine patch group (54.3%) failed their voiding trial than in the group that did not receive transdermal scopolamine (7.1%, P=<0.001). A history of an incontinence procedure, older age and higher body mass index strengthened the association between transdermal scopolamine patch and voiding trial failure. The adjusted model yielded a risk ratio for voiding trial failure of 13.8 (95% CI: 5.2-36.5) for women who received transdermal scopolamine patch compared to those who did not. Conclusions The results of this study demonstrate that use of transdermal scopolamine patches for postoperative nausea and vomiting prophylaxis may negatively affect the success of voiding trials after transobturator tape sling procedures.

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“…There was a low rate (5.2%) of PUR overall, and glycopyrrolate did not increase that risk 3 . Conversely, another retrospective review of 125 women undergoing pelvic reconstructive surgeries found that greater exposure to perioperative anticholinergic medications correlated with a higher risk of postoperative retention 19 …”

Section: Discussionmentioning

confidence: 93%

The role of perioperative medications in urinary retention following midurethral sling

Katz

Stensland

Alazem

et al. 2020

Neurourology and Urodynamics

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Aims: Postoperative urinary retention (PUR) is a known complication of midurethral sling (MUS) placement. The use of certain perioperative medications may influence the risk of this complication. This study aimed to investigate the association of perioperative medications with urinary retention after MUS. Methods: This was a retrospective study of women undergoing MUS placement for stress urinary incontinence by a fellowship-trained urologic surgeon between 2015 and 2018, under approval by the Institutional Review Board. Both retropubic and transobturator approaches were included. All patients underwent an active void trial following surgery. Intraoperative medications given by the anesthesia team were retrospectively noted. The Fisher's exact test was used to compare the association of PUR with categorical variables. Results: A total of 82 patients were included, 17 (21%) of whom failed postoperative void trial due to urinary retention. Of 25 patients receiving perioperative scopolamine, 40% failed the postoperative void trial, compared to 12% of patients not receiving scopolamine (p = .048). Groups were then stratified based on scopolamine use due to the observed independent association with PUR. Subgroup analysis revealed a stronger association of postoperative retention with scopolamine in patients undergoing concomitant prolapse surgery. Notably, retention rate and scopolamine use were similar whether patients underwent sling placement alone or in combination with prolapse surgery. Rate of retention was also higher for retropubic versus transobturator slings (36% vs. 9%; p = .005). Conclusions: Perioperative scopolamine may be associated with an increased risk of postoperative urinary retention following MUS, especially in the setting of a concomitant prolapse surgery.

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Perioperative Anticholinergic Medications and Risk of Catheterization After Urogynecologic Surgery

Abstract: Higher exposure to perioperative anticholinergic medications increases the risk of a failed postoperative VT after outpatient urogynecologic surgery.

Cited by 23 publications

References 21 publications

A Systematic Review of Randomized Trials Investigating Methods of Postoperative Void Trials Following Benign Gynecologic and Urogynecologic Surgeries

A Systematic Review of Randomized Trials Investigating Methods of Postoperative Void Trials Following Benign Gynecologic and Urogynecologic Surgeries

Effect of Scopolamine Patch Use on Postoperative Voiding Function After Transobturator Slings

The role of perioperative medications in urinary retention following midurethral sling

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