Phenazopyridine for Evaluation of Ureteral Patency

Propst, Katie; Tunitsky-Bitton, Elena; O’Sullivan, David; Steinberg, Adam C.; LaSala, Christine A.

doi:10.1097/aog.0000000000001472

Cited by 25 publications

(7 citation statements)

References 13 publications

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“…Other adverse effects include somnolence (20%), dizziness (8%), ataxia (13%), and fatigue (11%). Phenazopyridine (pyridium) 200 mg is a relatively low−risk intervention that can be given preoperatively as a urogesic and has been shown to increase voiding trial success rates [94]. Table 4 formulates a multimodal medication bundle for MIGS on the basis of these data.…”

Section: Multimodal Opioid-sparing Analgesiamentioning

confidence: 99%

Enhanced Recovery and Surgical Optimization Protocol for Minimally Invasive Gynecologic Surgery: An AAGL White Paper

Stone¹,

Carey

Fader³

et al. 2021

Journal of Minimally Invasive Gynecology

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This is the first Enhanced Recovery After Surgery (ERAS) guideline dedicated to standardizing and optimizing perioperative care for women undergoing minimally invasive gynecologic surgery. The guideline was rigorously formulated by an American Association of Gynecologic Laparoscopists Task Force of US and Canadian gynecologic surgeons with special interest and experience in adapting ERAS practices for patients requiring minimally invasive gynecologic surgery. It builds on the 2016 ERAS Society recommendations for perioperative care in gynecologic/oncologic surgery by serving as a more comprehensive reference for minimally invasive endoscopic and vaginal surgery for both benign and malignant gynecologic conditions. For example, the section on preoperative optimization provides more specific recommendations derived from the ambulatory surgery and anesthesia literature for the management of anemia, hyperglycemia, and obstructive sleep apnea. Recommendations pertaining to multimodal analgesia account for the recent Food and Drug Administration warnings about respiratory depression from gabapentinoids. The guideline focuses on workflows important to high-value care in minimally invasive surgery, such as same-day discharge, and tackles controversial issues in minimally invasive surgery, such as thromboprophylaxis. In these ways, the guideline supports the American Association of Gynecologic Laparoscopists and our collective mission to elevate the quality and safety of healthcare for women through excellence in clinical practice.

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Section: Multimodal Opioid-sparing Analgesiamentioning

confidence: 99%

Enhanced Recovery and Surgical Optimization Protocol for Minimally Invasive Gynecologic Surgery: An AAGL White Paper

Stone¹,

Carey

Fader³

et al. 2021

Journal of Minimally Invasive Gynecology

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show abstract

“…The use of opioids and tricyclic antidepressants in patients undergoing a hysterectomy was found to be associated with POUR 63 . Three RCTs in patients that had POP or SUI surgery showed no differences in using phenazopyridine to decrease the incidence of POUR 24,66,67 …”

Section: Discussionmentioning

confidence: 99%

“…RCTs have demonstrated that the use of phenazopyridine does not decrease the risk of POUR in patients having MUS or pelvic organ prolapse surgical procedures. 24,66,67 87.50…”

Section: Q17 Does the Use Of Analgesics During Surgery Increase The I...mentioning

confidence: 99%

“…63 Three RCTs in patients that had POP or SUI surgery showed no differences in using phenazopyridine to decrease the incidence of POUR. 24,66,67 Minimizing surgical time (less than 110 minutes) may reduce the risk of POUR with heterogeneous conclusions for how much operative time is a risk factor. 20,29,68 The data on blood loss as it relates to POUR are mixed, with 2 studies in gynecologic populations showing no impact, 69,132 and a retrospective review of patients undergoing POP surgery demonstrating that blood loss greater than 100 mL was associated with POUR.…”

Section: Postoperative Urinary Retentionmentioning

confidence: 99%

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Postoperative Urinary Retention

McDermott

Tunitsky-Bitton

Dueñas-García

et al. 2023

UROGC

Self Cite

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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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“…Race was dichotomized into White or non-White for our analysis. Factors that could potentially affect voiding dysfunction (Charlson Comorbidity Index, operative time, and preoperative phenazopyridine administration) were also included as covariates in our model 9 . Charlson Comorbidity Index scores were split into mild risk (scores of 0–2) versus moderate/severe risk (scores of 3 or greater) categories for the regression analysis.…”

Section: Methodsmentioning

confidence: 99%

Are Formal Voiding Trials Necessary After Posterior Compartment Reconstructive Surgery?

Askew

Margulies

Sakai

et al. 2022

Female Pelvic Med Reconstr Surg

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Importance Posterior compartment surgery is considered a risk factor for postoperative urinary retention because of the impact of postoperative pain on the pelvic floor; however, few studies have examined the association between posterior compartment reconstructive surgery and urinary retention.Objective The aim of the study was to compare rates of urinary retention in patients undergoing vaginal reconstructive surgery, without hysterectomy, in the posterior compartment only versus any apical and/or anterior compartment (with or without posterior compartment). Study Design In this retrospective cohort study, we evaluated patients who underwent surgery, without hysterectomy, in the posterior compartment only versus any apical and/or anterior compartment (with or without posterior compartment) from January 2015 to November 2020. Our primary outcome was rate of postoperative urinary retention, defined as a failed voiding trial before discharge. Secondary outcome was days of catheterization. Multivariable logistic regression was performed to assess variables associated with a failed voiding trial. Results Of 362 patients, 141 (39.0%) underwent surgery in the posterior compartment only and 221 (61.0%) underwent vaginal apical and/or anterior compartment surgical procedures. Rate of retention was significantly lower in the posterior compartment only group (9.9% vs 41.6%, P < 0.001). The median numbers of days of catheterization were significantly fewer in the posterior compartment only group (0 [0,0] vs 0 [0,3], P < 0.001). In multivariable logistic regression, posterior compartment only surgery was associated with passing the voiding trial (odds ratio, 6.0; 95% confidence interval, 2.97-12.03). Conclusions Rates of postoperative urinary retention after surgery in the posterior compartment are low, and these patients may not require formal voiding trials after surgery.

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Phenazopyridine for Evaluation of Ureteral Patency

Abstract: ClinicalTrials.gov, https://clinicaltrials.gov/, NCT02424149.

Cited by 25 publications

References 13 publications

Enhanced Recovery and Surgical Optimization Protocol for Minimally Invasive Gynecologic Surgery: An AAGL White Paper

Enhanced Recovery and Surgical Optimization Protocol for Minimally Invasive Gynecologic Surgery: An AAGL White Paper

Postoperative Urinary Retention

Are Formal Voiding Trials Necessary After Posterior Compartment Reconstructive Surgery?

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