Department of Urogynecology, Cambridge University Hospital NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, United Kingdom.
Emergency Department, The Hillingdon Hospitals NHS Foundation Trust, Pield Heath Road, Uxbridge UB8 3NN, United Kingdom.
Eur J Obstet Gynecol Reprod Biol. 2021 Aug;263:127-131. doi: 10.1016/j.ejogrb.2021.06.011. Epub 2021 Jun 15.
Short-term postoperative voiding dysfunction (POVD) is common in women undergoing surgery for pelvic organ prolapse. It results in increased catheter burden for patients and health services, and catheter-associated urinary tract infections (CAUTIs), thereby escalating the overall cost of treatment. Our aim was to determine the risk factors for voiding dysfunction following surgery for POP in our unit.
A retrospective case-control study conducted in a tertiary center in the U.K. The study cohort included all women who underwent surgery for pelvic organ prolapse between March 2017 and March 2019 and had a failed trial without catheter (TWOC). The control group comprised consecutive women on the surgical database who passed TWOC. Relevant data, including demographic details, past medical history, intraoperative and postoperative factors, were collected. We used the Chi-square test to calculate the statistical significance and multiple logistic regression analysis using SPSS software to identify the risk factors.
286 surgeries were performed. After exclusion, 43 patients were included in each group. Baseline demographics were similar in both groups. The incidence of POVD was 15%, and none of our patients had long-term voiding problems. Logistic regression analysis identified five risk factors - advanced pelvic organ prolapse (OR = 2.654, p = 0.029), comorbidities (OR = 4.583, p = 0.019), preoperative anticholinergics and/or antidepressants (OR = 4.440, p = 0.004), sacrospinous hysteropexy/colpopexy (OR = 2.613, p = 0.041) and postoperative opioid use (OR = 3.529, p = 0.004).
We identified five risk factors to recognize the women who would benefit from advanced counseling and management plan following surgery for pelvic organ prolapse.
盆腔器官脱垂患者术后短期排尿功能障碍（POVD）较为常见。这会增加患者和医疗服务的导管负担，并导致与导管相关的尿路感染（CAUTIs），从而增加整体治疗成本。我们的目的是确定我们单位行盆腔器官脱垂手术后排尿功能障碍的危险因素。
这是在英国一家三级中心进行的回顾性病例对照研究。研究队列包括 2017 年 3 月至 2019 年 3 月期间因盆腔器官脱垂而行手术且无导管试验失败（TWOC）的所有女性。对照组由连续接受 TWOC 的手术数据库中的女性组成。收集了包括人口统计学细节、既往病史、术中及术后因素在内的相关数据。我们使用卡方检验计算统计学意义，使用 SPSS 软件进行多因素逻辑回归分析，以确定危险因素。
共进行了 286 例手术。排除后，每组纳入 43 例患者。两组的基线人口统计学特征相似。POVD 的发生率为 15%，我们的患者均无长期排尿问题。逻辑回归分析确定了 5 个危险因素——晚期盆腔器官脱垂（OR=2.654，p=0.029）、合并症（OR=4.583，p=0.019）、术前使用抗胆碱能药物和/或抗抑郁药（OR=4.440，p=0.004）、骶骨阴道固定术/阴道骶骨固定术（OR=2.613，p=0.041）和术后使用阿片类药物（OR=3.529，p=0.004）。
我们确定了 5 个危险因素，可以识别出在盆腔器官脱垂手术后需要接受高级咨询和管理计划的女性。
