Urinary retention after AdVance™ Sling: A multi-institutional retrospective study

Area of Science:

• Urology
• Surgical Innovation
• Patient Outcomes

Background:

• Post-prostatectomy stress urinary incontinence (SUI) affects many patients.
• The AdVance™ Sling is a surgical option for SUI.
• Urinary retention is a potential complication of sling procedures.

Purpose of the Study:

• To identify risk factors for urinary retention after AdVance™ Sling placement.
• To evaluate the role of preoperative urodynamic studies in predicting urinary retention.
• To assess the impact of bladder contractility on postoperative outcomes.

Main Methods:

• Multi-institutional retrospective review of 391 patients undergoing AdVance™ Sling placement for post-prostatectomy SUI (2007-2019).
• Acute urinary retention (AUR) defined by inability to void or elevated post-void residual (PVR) requiring catheterization.
• Preoperative urodynamic studies were used to assess bladder contractility.

Main Results:

• 14.1% of patients experienced AUR; 1.5% had chronic retention.
• No significant difference in preoperative urodynamic parameters (PdetQmax, Qmax, PVR, bladder contractility index) between patients with or without AUR.
• Impaired bladder contractility was not predictive of AUR. Shorter time to postoperative urethral catheter removal predicted AUR (OR 0.83, p=0.003).

Conclusions:

• Chronic urinary retention is uncommon after AdVance™ Sling placement and acute retention is typically self-limiting.
• No demographic or urodynamic factors predicted AUR.
• A longer duration of postoperative catheterization may decrease the incidence of AUR.