Khin Kaythi, Adair Shaun T, Dhariwal Laura, Wasenda Erika, Leong Ellie, Chiu Stephanie, Botros Carolyn
From the Division of Urogynecology and Reconstructive Pelvic Surgery, Atlantic Health System, Morristown, NJ.
Urogynecology (Phila). 2025 Jul 1;31(7):669-674. doi: 10.1097/SPV.0000000000001529. Epub 2024 May 10.
Understanding the risk of urinary retention with different prolapse repair surgical procedures is important for perioperative counseling.
The study compared postoperative urinary retention rates between robotic sacrocolpopexy and robotic uterosacral ligament suspension.
This institutional review board-exempt retrospective cohort study compared patients who underwent pelvic organ prolapse repair with robotic sacrocolpopexy (RSCP) and robotic uterosacral ligament suspension (RUSLS) between June 2018 and March 2022. Our primary outcome was the rate of acute postoperative urinary retention (POUR) in these groups. Secondary outcomes were the number of days needed to resolve urinary retention and persistent voiding dysfunction.
Out of 298 patients, 258 underwent RSCP and 40 underwent RUSLS. Acute POUR was found in 73 patients (24%): 46 patients (18%) in the RSCP group versus 26 patients (65%) in the RUSLS group ( P < 0.001). Multivariate analysis demonstrated a significantly higher rate of acute POUR after RUSLS (odds ratio [OR] = 17.92, confidence interval [CI] = 3.06-104.86; P = 0.001). Patients with an elevated preoperative postvoid residual volume >100 mL or concomitant midurethral sling were more likely to develop POUR (OR = 2.93, CI = 1.43-5.98; P = 0.003 and OR = 2.19, CI = 1.16-4.14; P = 0.016, respectively). While patients with higher parity were less likely to have urinary retention (OR = 0.71, CI = 0.53-0.96; P = 0.024), age, body mass index, prolapse stage, and concurrent posterior repair did not affect the urinary retention rate significantly. The number of days needed to resolve POUR and persistent voiding dysfunction were similar.
Acute POUR appears more likely to develop after RUSLS compared to RSCP. Elevated preoperative postvoid residual volume and concomitant midurethral sling surgery independently increase the risk of POUR.
了解不同盆底器官脱垂修复手术方法导致尿潴留的风险，对于围手术期咨询很重要。
本研究比较了机器人骶骨阴道固定术和机器人子宫骶骨韧带悬吊术的术后尿潴留率。
这项经机构审查委员会豁免的回顾性队列研究，比较了2018年6月至2022年3月期间接受机器人骶骨阴道固定术（RSCP）和机器人子宫骶骨韧带悬吊术（RUSLS）进行盆腔器官脱垂修复的患者。我们的主要结局是这些组中的急性术后尿潴留（POUR）发生率。次要结局是解决尿潴留和持续性排尿功能障碍所需的天数。
在298例患者中，258例行RSCP，40例行RUSLS。73例患者（24%）发生急性POUR：RSCP组46例（18%），RUSLS组26例（65%）（P<0.001）。多因素分析显示，RUSLS术后急性POUR发生率显著更高（比值比[OR]=17.92，置信区间[CI]=3.06 - 104.86；P = 0.001）。术前排尿后残余尿量>100 mL或同时行尿道中段吊带术的患者更易发生POUR（OR分别为2.93，CI = 1.43 - 5.98；P = 0.003和OR = 2.19，CI = 1.16 - 4.14；P = 0.016）。而产次较高的患者发生尿潴留的可能性较小（OR = 0.71，CI = 0.53 - 0.96；P = 0.024），年龄、体重指数、脱垂分期和同期后路修复对尿潴留率无显著影响。解决POUR和持续性排尿功能障碍所需的天数相似。
与RSCP相比，RUSLS术后似乎更易发生急性POUR。术前排尿后残余尿量增加和同时行尿道中段吊带术独立增加POUR风险。
