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Early voiding dysfunction after midurethral sling surgery: comparison of two management approaches
Erin A Brennand1, Selphee Tang2, Colin Birch3
1Division of Urogynecology, Department of Obstetrics & Gynecology, University of Calgary, 4th floor, North Tower, Foothills Hospital, 1403-29 Street NW, Calgary, AB, Canada, T2N 2T9. Erin.brennand@albertahealthservices.ca.
International Urogynecology Journal
|March 13, 2017
Summary
Early voiding dysfunction after midurethral sling surgery can resolve with mobilization or continued catheterization. Mobilization may reduce recurrent stress urinary incontinence risk compared to delayed sling lysis.
Area of Science:
- Urology
- Gynecologic Surgery
Background:
- Early voiding dysfunction (EVD) with urinary retention (UR) is a known complication following midurethral sling (MUS) procedures.
- Current management strategies for EVD post-MUS are not standardized, leading to varied patient outcomes.
Purpose of the Study:
- To characterize management approaches for EVD after MUS surgery at a single center.
- To report outcomes including UR resolution, persistent voiding dysfunction, and recurrent stress urinary incontinence (SUI).
Main Methods:
- A prospective study included women with EVD requiring catheterization for ≥7 days post-MUS.
- Management plans were determined jointly by surgeon and patient.
- Urinary symptom questionnaires were administered at baseline, 3, and 6 months post-surgery.
Main Results:
- Two management groups emerged: early mobilization (n=10) and continued catheterization with delayed sling lysis (n=21).
- UR resolved in all mobilization patients after 1-2 interventions; 50% of catheterization patients resolved without intervention.
- Mobilization group had significantly lower SUI at 6 months (0%) vs. catheterization group (45%, p=0.029), particularly those undergoing sling lysis.
Conclusions:
- Urinary retention post-MUS often resolves with continued catheterization, but mobilization is a viable alternative.
- Early intervention via mobilization may decrease the risk of recurrent SUI compared to delayed sling lysis.
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