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腹腔镜子宫切除术后留置膀胱冲洗液对机体的影响:一项随机对照试验。

Impact of Retained Cystoscopy Fluid after Laparoscopic Hysterectomy: A Randomized Controlled Trial.

机构信息

Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Banner-University Medical Center Phoenix, University of Arizona College of Medicine, Phoenix (Drs. Smith, Mahnert, Steck-Bayat, Womack, and Mourad).

Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Banner-University Medical Center Phoenix, University of Arizona College of Medicine, Phoenix (Drs. Smith, Mahnert, Steck-Bayat, Womack, and Mourad).

出版信息

J Minim Invasive Gynecol. 2021 Feb;28(2):288-296. doi: 10.1016/j.jmig.2020.05.024. Epub 2020 Jun 4.

Abstract

STUDY OBJECTIVE

To investigate the impact of retained cystoscopy fluid after laparoscopic hysterectomy on time to spontaneous void, time to discharge, urinary retention, bladder discomfort, and patient satisfaction.

DESIGN

Single-blind randomized controlled trial.

SETTING

An academic medical center.

PATIENTS

One hundred and twenty patients who underwent laparoscopic hysterectomy with universal cystoscopy for benign indications, excluding pelvic organ prolapse and urinary incontinence indications.

INTERVENTIONS

From October 10, 2018, to October 17, 2019, we compared 200 mL retained cystoscopy fluid and complete bladder emptying after laparoscopic hysterectomy with universal cystoscopy.

MEASUREMENTS AND MAIN RESULTS

A total of 120 patients were enrolled and randomized (59 in the retained cystoscopy fluid group and 61 in the emptied fluid group). The primary outcome was time to first spontaneous void. The secondary outcomes were time to discharge, urinary retention rates, bladder discomfort, and patient satisfaction. A sample size of 120 was calculated to detect a 57-minute difference in time to spontaneous void. There were minimal differences in baseline demographics and surgical characteristics between the groups. There was an apparent, although not significant, difference in time to void of 25 minutes (143 minutes vs 168 minutes, p = .20). Time to discharge and urinary retention rates did not differ (199 minutes vs 214 minutes, p = .40, and 13.6% vs 8.2%, p = .51, respectively). There was no difference in postoperative bladder discomfort and patient satisfaction.

CONCLUSION

Retained cystoscopy fluid after laparoscopic hysterectomy did not significantly affect time to first spontaneous void, time to discharge, urinary retention, bladder discomfort, or patient satisfaction.

摘要

研究目的

探讨腹腔镜子宫切除术后保留膀胱镜冲洗液对自主排尿时间、出院时间、尿潴留、膀胱不适和患者满意度的影响。

设计

单盲随机对照试验。

设置

学术医疗中心。

患者

120 例因良性指征行腹腔镜子宫切除术且行常规膀胱镜检查的患者,不包括盆腔器官脱垂和尿失禁指征。

干预

2018 年 10 月 10 日至 2019 年 10 月 17 日,我们比较了腹腔镜子宫切除术后保留 200ml 膀胱镜冲洗液和排空冲洗液对常规膀胱镜检查的影响。

测量和主要结果

共纳入并随机分配 120 例患者(保留膀胱镜冲洗液组 59 例,排空冲洗液组 61 例)。主要结局为首次自主排尿时间。次要结局为出院时间、尿潴留发生率、膀胱不适和患者满意度。计算样本量为 120 例,以检测自主排尿时间差异 57 分钟。两组患者的基线人口统计学和手术特征差异极小。排尿时间差异明显,但无统计学意义,差异为 25 分钟(143 分钟比 168 分钟,p=0.20)。出院时间和尿潴留发生率无差异(199 分钟比 214 分钟,p=0.40,13.6%比 8.2%,p=0.51)。术后膀胱不适和患者满意度无差异。

结论

腹腔镜子宫切除术后保留膀胱镜冲洗液不会显著影响首次自主排尿时间、出院时间、尿潴留、膀胱不适或患者满意度。

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