Carter-Brooks Charelle M, Zyczynski Halina M, Moalli Pamela A, Brodeur Peter G, Shepherd Jonathan P
Division of Urogynecology and Reconstructive Surgery, Department of Obstetrics, Gynecology and Reproductive Sciences of the University of Pittsburgh, Magee-Womens Hospital of the University of Pittsburgh Medical Center, 300 Halket Street, Suite 2323, Pittsburgh, PA, USA.
Department of Obstetrics and Gynecology, Trinity Health of New England, Hartford, CT, USA.
Int Urogynecol J. 2018 Aug;29(8):1203-1212. doi: 10.1007/s00192-018-3641-3. Epub 2018 Mar 29.
Studies have yet to examine the impact of day-of-surgery voiding trials on post-operative urinary retention in women undergoing obliterative and apical suspension procedures for pelvic organ prolapse. Our objective was to evaluate if time to spontaneous void after these procedures is shorter when a voiding trial is performed on the day of surgery compared with our standard practice of post-operative day 1.
We conducted a randomized, parallel-arm trial in patients undergoing major pelvic floor reconstructive surgery. Women were randomized 1:1 to an early (4 h post-operatively on the day of surgery) or a standard (6 am on post-operative day 1) retrograde voiding trial.
A total of 57 women consented. Mean age and BMI were 65 ± 11 and 27.9 ± 4.4. Most women had stage III pelvic organ prolapse (77.2%). Groups had similar baseline characteristics. In the intention-to-treat analysis (n = 57), there was no difference in time to spontaneous void in the early versus standard voiding trial groups (15.9 ± 3.8 vs 28.4 ± 3.1 hours, p = 0.081). In the adjusted analysis using mutlivariable linear regression, an early voiding trial decreased the time to spontaneous void (abeta -2.00 h, p = 0.031) when controlling for vaginal packing and stage IV prolapse. In the per-protocol analysis, which excluded 4 patients for crossover, spontaneous void occurred 17 hours faster in the early voiding trial group (14.6 ± 3.7 vs 31.8 ± 2.9 hours; p = 0.022). Early voiding trial patients experienced ambulation sooner and more often than the standard group (p = 0.02).
A day-of-surgery voiding trial did not prolong catheter use after obliterative and apical suspension procedures.
对于接受盆腔器官脱垂闭塞和顶端悬吊手术的女性，目前尚无研究探讨手术当天排尿试验对术后尿潴留的影响。我们的目的是评估与术后第1天进行排尿试验的标准做法相比，在手术当天进行排尿试验时，这些手术后自然排尿的时间是否更短。
我们对接受大型盆底重建手术的患者进行了一项随机平行组试验。女性患者按1:1随机分为早期组（术后4小时）或标准组（术后第1天上午6点）逆行排尿试验。
共有57名女性同意参与。平均年龄和体重指数分别为65±11岁和27.9±4.4。大多数女性患有III期盆腔器官脱垂（77.2%）。两组的基线特征相似。在意向性分析（n = 57）中，早期排尿试验组与标准排尿试验组自然排尿时间无差异（15.9±3.8小时对28.4±3.1小时，p = 0.081）。在使用多变量线性回归的调整分析中，在控制阴道填塞和IV期脱垂时，早期排尿试验缩短了自然排尿时间（β=-2.00小时，p = 0.031）。在排除交叉的4名患者的符合方案分析中，早期排尿试验组自然排尿时间快17小时（14.6±...
