Chong Chul, Kim Hye Sung, Suh Dong Hoon, Jee Byung Chul
Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea.
Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.
Obstet Gynecol Sci. 2016 Mar;59(2):137-43. doi: 10.5468/ogs.2016.59.2.137. Epub 2016 Mar 16.
To evaluate the risk factors for postoperative urinary retention in women who underwent vaginal hysterectomy for symptomatic pelvic organ prolapse.
The medical records of 221 women who underwent vaginal hysterectomy with anterior and posterior colporrhapy were reviewed. Urinary retention after catheter removal was defined as the presence of at least one of the following three conditions: 1) failure of first voiding trial necessitating catheterization, 2) first residual urine volume after self-voiding ≥150 mL, and 3) Foley catheter re-insertion.
Urinary retention occurred in 60 women (27.1%). Multivariate and receiver operating characteristic curve analysis revealed that age (>63 years) and early postoperative day of catheter removal (day 1) was independent predictor for postoperative urinary retention. The incidence of urinary retention was significantly higher in women who removed indwelling catheter at day 1 (35.2%) than those at day 2 (12.0%, P=0.024), or day 3 (21.3%, P=0.044), but was similar to those at day 4 (25.0%, P=0.420). In women ≤63 years, urinary retention rate was not associated with the time of catheter removal after surgery; however, in women >63 years, the rate was significantly higher in day 1 removal group than day 2 to 4 removal group.
Age and postoperative day of catheter removal appear to be associated with postoperative urinary retention in women undergoing vaginal hysterectomy for pelvic organ prolapse. Keeping urinary catheter in situ at least for one day after vaginal prolapse surgery could be recommended, especially, in women older than 63 years.
评估因有症状的盆腔器官脱垂而接受阴道子宫切除术的女性术后尿潴留的危险因素。
回顾了221例行阴道子宫切除术及前后阴道壁修补术的女性的病历。拔除导尿管后尿潴留定义为出现以下三种情况中的至少一种：1）首次排尿试验失败需要再次导尿；2）自行排尿后首次残余尿量≥150ml；3）重新插入Foley导尿管。
60名女性（27.1%）发生尿潴留。多因素及受试者工作特征曲线分析显示，年龄（>63岁）和术后早期拔除导尿管（第1天）是术后尿潴留的独立预测因素。术后第1天拔除留置导尿管的女性尿潴留发生率（35.2%）显著高于第2天（12.0%，P=0.024）或第3天（21.3%，P=0.044）拔除导尿管的女性，但与第4天（25.0%，P=0.420）拔除导尿管的女性相似。在年龄≤63岁的女性中，尿潴留率与术后拔除导尿管的时间无关；然而，在年龄>63岁的女性中，第1天拔除导尿管组的尿潴留率显著高于第2至4天拔除导尿管组。
年龄和术后拔除导尿管的时间似乎与因盆腔器官脱垂接受阴道子宫切除术的女性术后尿潴留有关。建议阴道脱垂手术后至少保留导尿管一天，尤其是63岁以上的女性。
