Wang Rui, Won Sara, Haviland Miriam J, Von Bargen Emily, Hacker Michele R, Li Janet, Lefevre Roger
Harvard Medical School, Boston, MA, USA.
Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Int Urogynecol J. 2016 Aug;27(8):1215-20. doi: 10.1007/s00192-016-2975-y. Epub 2016 Feb 17.
Our aim was to identify predictors of postoperative voiding trial failure among patients who had a pelvic floor repair without a concurrent incontinence procedure in order to identify low-risk patients in whom postoperative voiding trials may be modified.
We conducted a retrospective cohort study of women who underwent pelvic floor repair without concurrent incontinence procedures at two institutions from 1 November 2011 through 13 October 2013 after abstracting demographic and clinical data from medical records. The primary outcome was postoperative retrograde voiding trial failure. We used modified Poisson regression to calculate the risk ratio (RR) and 95 % confidence interval (CI).
Of the 371 women who met eligibility criteria, 294 (79.2 %) had complete data on the variables of interest. Forty nine (16.7 %) failed the trial, and those women were less likely to be white (p = 0.04), more likely to have had an anterior colporrhaphy (p = 0.001), and more likely to have had a preoperative postvoid residual (PVR) ≥150 ml (p = 0.001). After adjusting for race, women were more likely to fail their voiding trial if they had a preoperative PVR of ≥150 ml (RR: 1.9; 95 % CI: 1.1-3.2); institution also was associated with voiding trial failure (RR: 3.0; 95 % CI: 1.6-5.4).
Among our cohort, postoperative voiding trial failure was associated with a PVR of ≥150 ml and institution at which the surgery was performed.
我们的目的是确定在未同时进行尿失禁手术的盆底修复患者中,术后排尿试验失败的预测因素,以便识别可能需要调整术后排尿试验的低风险患者。
我们对2011年11月1日至2013年10月13日期间在两家机构接受未同时进行尿失禁手术的盆底修复的女性进行了一项回顾性队列研究,从病历中提取了人口统计学和临床数据。主要结局是术后逆行排尿试验失败。我们使用修正泊松回归来计算风险比(RR)和95%置信区间(CI)。
在符合纳入标准的371名女性中,294名(79.2%)有关于感兴趣变量的完整数据。49名(16.7%)试验失败,这些女性不太可能是白人(p = 0.04),更有可能接受过前阴道壁修补术(p = 0.001),并且更有可能术前残余尿量(PVR)≥150 ml(p = 0.001)。在调整种族因素后,如果女性术前PVR≥150 ml,则她们排尿试验失败的可能性更大(RR:1.9;95% CI:1.1 - 3.2);机构也与排尿试验失败相关(RR:3.0;95% CI:1.6 - 5.4)。
在我们的队列中,术后排尿试验失败与PVR≥150 ml以及手术所在机构有关。