Incidence and predictors of prolonged urinary retention after TVT with and without concurrent prolapse surgery

The purpose of this study was to describe the time to adequate voiding, incidence of urinary retention, and predictors of voiding efficiency and urinary retention after tension-free vaginal tape (TVT) with and without concurrent prolapse surgery.

Medical records of patients who underwent TVT between August 1999 and July 2003 were reviewed. Urinary retention was defined as the need for urethrolysis, urethral dilation, or postoperative catheterization for >6 weeks. Linear and logistic regression models were used to determine predictors of time to adequate voiding and urinary retention.

Two hundred sixty-seven patients were available for analysis; 66% had concurrent prolapse repair, 4% had concurrent laparoscopically assisted vaginal hysterectomy (LAVH), and 30% had an isolated TVT. TVT with and without concurrent prolapse repair or LAVH were statistically similar with respect to median days to voiding (8 vs 5) and the rate of urinary retention (11.2% vs 11.3%). Overall, 4.9% underwent urethrolysis, 1.9% received urethral dilation, and 4.1% required prolonged catheterization. Increasing age, decreasing BMI, and postoperative urinary tract infection were independent predictors of time to adequate voiding. Previous history of incontinence surgery was the only independent predictor of urinary retention (Adjusted odds ratio [AOR] 2.96, 95%CI [1.17-7.06]).

Concurrent prolapse surgery does not appear to significantly alter postoperative voiding efficiency or increase the risk of prolonged urinary retention compared with TVT alone.