Postoperative voiding dysfunction following posterior colporrhaphy

The primary objective of this study was to evaluate the rate of postoperative urinary retention in patients undergoing posterior colporrhaphy. This is compared with the rate of postoperative urinary retention in patients undergoing suburethral sling placement.

A retrospective analysis of women treated surgically for either a symptomatic posterior compartment defect or stress urinary incontinence was performed. The preoperative, operative, and postoperative records of women who underwent a sole procedure of a posterior colporrhaphy or tension-free suburethral sling by 2 fellowship-trained urogynecologists were reviewed and compared.

Significantly more posterior colporrhaphy patients failed their voiding trial (32.4% ± 12%) than suburethral sling patients (15% ± 17%; P = 0.030). After replacement of a Foley catheter, the total length of catheterization was longer in the posterior colporrhaphy group (3.2 ± 0.9 days) than that in the suburethral sling group (1.8 ± 0.4 days; P = 0.007). No patients in either group demonstrated long-term voiding dysfunction, and no patients required further surgical management to reverse their transient voiding dysfunction.

In this study, the rate of postoperative transient urinary retention following posterior colporrhaphy is 32.4%, which is significantly higher than the rate observed following suburethral sling placement. Although the reason for this higher rate is unclear, it may be related to postoperative pain. Although it is standard practice to assess voiding function after suburethral sling placement, the findings of our study suggest that physicians should also consider assessing postoperative voiding function following posterior colporrhaphy.