Utility of Postoperative Voiding Cystourethrogram After Lower Urinary Tract Repair

To characterize indications, timing, and results of voiding cystourethrogram (VCUG) studies after repair of the lower urinary tract and to determine how these results impact clinical management.

Women who underwent a VCUG between January 2006 and December 2012 were identified from a radiology billing database. After excluding women with abdominopelvic malignancies, demographic, clinical, index procedure and lower urinary tract repair characteristics, and VCUG results were analyzed. The impact of abnormal VCUG results on clinical management was assessed.

Data were analyzed from 245 VCUG studies performed a median of 10 days (interquartile range, 8-12 days) after lower urinary tract repair. When classified by procedure type, VCUGs were performed a median of 9 days (7-13 days) after cystotomy repair, 11 days (10-12 days) after vesicovaginal fistula closure and 10 days (7-11 days) after diverticulectomy. Abnormal findings were noted in 7 of 245 (2.9%) VCUGs and included contrast extravasation (5/7) and urinary retention (2/7). In all cases, the abnormal VCUG prompted a change in clinical management with extended use of an indwelling catheter or intermittent self-catheterization in 1 case of urinary retention.

Voiding cystourethrograms are a useful clinical tool in guiding the duration of Foley catheter use after lower urinary tract repair. Depending on clinical practice, VCUGs may reduce catheter-associated morbidity by facilitating earlier catheter removal and, in the minority of cases, may identify patients with incomplete postoperative healing.