Abstract
The aim of this study was to determine the prevalence of postoperative urinary retention (PU) based on preoperative estimation of bladder capacity in gynecologic patients and to evaluate the reliability of clinical examination in diagnosing PU. Over a 3-year period 284 consecutive patients undergoing surgical intervention were included in the study. Bladder capacity was assessed preoperatively. If PU was suspected a clinical examination, bladder scan and catheterization were performed. The prevalence of postoperative urinary retention was 9.2%. There was a significant association between PU and the type of operation, but not with the type or the duration of anesthesia or total blood loss. Clinical examination was reliable, with a positive and negative predictive value of 76.2% and 100%, respectively. In conclusion, PU is a substantial problem after gynecologic surgery. Patients at risk are difficult to predict. The risk is higher after laparotomy than after laparoscopy. The clinical diagnosis is fairly accurate.
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Abbreviations
- PU:
-
postoperative urinary retention
- LAVH:
-
laparoscopically assisted vaginal hysterectomy
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Editorial Comment: The authors stated their aim for this study was to determine the prevalence of postoperative urinary retention in gynecologic patients and to evaluate the reliability of clinical examination in its diagnosis. They found that 14% of patients undergoing abdominal hysterectomy developed postoperative urinary retention compared to only 8% of those undergoing laparoscopically assisted vaginal hysterectomy. The incidence was only 2% after laparoscopy. Interestingly, they found no correlation between preoperative residual urine volumes or bladder capacity and the development of postoperative urinary retention.
The authors reported that clinical examination was fairly reliable in detecting urinary retention in the postoperative patient (positive predictive value of 76%), and very reliable in ruling it out (negative predictive value of 100%). The incidence of postoperative urinary retention has proven to be correlated with the length of time that the catheter remains in place. A major weakness of this study is that the authors did not report the time interval between the surgical procedures and the removal of the catheters.
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Bødker, B., Lose, G. Postoperative urinary retention in gynecologic patients. Int Urogynecol J 14, 94–97 (2003). https://doi.org/10.1007/s00192-003-1038-3
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DOI: https://doi.org/10.1007/s00192-003-1038-3