From the Department of OB/GYN, Division of Female Pelvic Medicine and Reconstructive Surgery, University of North Carolina at Chapel Hill.
Department of OB/GYN, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Female Pelvic Med Reconstr Surg. 2021 Feb 1;27(2):e256-e260. doi: 10.1097/SPV.0000000000000743.
This study aimed to compare a backfill-assisted voiding trial (VT) with and without a postvoid residual (PVR) after pelvic reconstructive surgery.
This was a nonblinded randomized controlled trial of women undergoing pelvic organ prolapse and/or stress incontinence surgery. Participants were randomized immediately after surgery to either a PVR VT or a PVR-free VT. Our primary outcome was the rate of VT failure at discharge. Secondary outcomes included days of catheterization, urinary tract infection (UTI), and prolonged voiding dysfunction. With a power of 80% and an α of 0.05, we needed 126 participants to detect a 25% difference in VT failure (60% in PVR VT vs 35% in PVR-free VT).
Participants were enrolled from March 2017 to October 2017. Of the 150 participants, mean age was 59 years, and 33% underwent vaginal hysterectomy, 48% underwent anterior repair, and 75% underwent midurethral sling. Seventy-five (50%) were randomized to PVR VT and 75 (50%) to PVR-free VT, with no differences in baseline demographic or intraoperative characteristics between the 2 groups. Our primary outcome, VT failure, was not significantly different (53% PVR VT vs 53% PVR-free VT, P = 1.0). There were no significant differences in days of postoperative catheterization (1 [0, 4] in PVR VT vs 1 [0, 4] in PVR-free VT, P = 0.90), UTI (20% PVR VT vs 20% PVR-free VT, P = 1.0), or postoperative voiding dysfunction (4% PVR VT vs 5% PVR-free VT, P = 1.0).
When performing a backfill-assisted VT, checking a PVR does not affect VT failure, postoperative duration of catheterization, UTI, or voiding dysfunction.
本研究旨在比较骨盆重建手术后有和没有导尿后残余（PVR）的辅助排空试验（VT）。
这是一项针对行盆腔器官脱垂和/或压力性尿失禁手术的女性的非盲随机对照试验。参与者在手术后立即随机分为 PVR-VT 或 PVR 无 VT。我们的主要结局是出院时 VT 失败的发生率。次要结局包括导尿天数、尿路感染（UTI）和排尿功能障碍延长。在 80%的功效和 0.05 的α水平下，我们需要 126 名参与者来检测 VT 失败率（PVR-VT 中为 60%，PVR 无 VT 中为 35%）的 25%差异。
参与者于 2017 年 3 月至 2017 年 10 月入选。150 名参与者中，平均年龄为 59 岁，33%行阴道子宫切除术，48%行前修补术，75%行中尿道吊带术。75 人（50%）被随机分配到 PVR-VT，75 人（50%）被随机分配到 PVR 无-VT，两组间基线人口统计学或术中特征无差异。我们的主要结局，VT 失败，无显著差异（PVR-VT 中为 53%，PVR 无-VT 中为 53%，P=1.0）。术后导尿天数（PVR-VT 中为 1[0，4]，PVR 无-VT 中为 1[0，4]，P=0.90）、UTI（PVR-VT 中为 20%，PVR 无-VT 中为 20%，P=1.0）或术后排尿功能障碍（PVR-VT 中为 4%，PVR 无-VT 中为 5%，P=1.0）无显著差异。
在进行辅助排空试验时，检查 PVR 并不影响 VT 失败、术后导尿时间、UTI 或排尿功能障碍。
