Related Experiment Video
Updated: Jan 11, 2026
03:25
Transcorporal Artificial Urinary Sphincter Cuff Placement in a Case Requiring Revision for Urethral Atrophy
Published on: June 16, 2022
1.3K
Guarding Reflex Inhibition Training Reduces Postoperative Urinary Retention After Urethral Bulking for Stress Urinary
Nicole Fleischmann1, Marlena Plagianos2, Rachel Meiselman1
1White Plains Hospital Center, 41 East Post Road, White Plains, NY 10601, USA.
Journal of Clinical Medicine
|November 13, 2025
Summary
Preoperative Guarding Reflex Inhibition Training (GRIT) significantly reduced postoperative urinary retention (POUR) in women undergoing stress urinary incontinence surgery. This behavioral approach offers a promising adjunct to procedural therapies for incontinence.
Area of Science:
- Urology
- Behavioral Medicine
Background:
- Postoperative urinary retention (POUR) affects 10-15% of women post-stress urinary incontinence (SUI) surgery.
- Guarding Reflex Inhibition Training (GRIT) is a novel behavioral method to consciously inhibit pelvic floor muscle contractions.
Purpose of the Study:
- To evaluate the association between preoperative GRIT and reduced POUR after urethral bulking with polyacrylamide hydrogel (PAHG).
Main Methods:
- Retrospective review of 145 women with SUI.
- Comparison of POUR rates between patients who received preoperative GRIT and those who did not.
- POUR defined as >1 straight catheterization or catheter discharge.
Main Results:
- POUR occurred in 14.2% of patients without GRIT versus 0% with GRIT (p=0.012).
- GRIT demonstrated a 14.2% absolute risk reduction and a number needed to treat of 7.
- Statistical power exceeded 90%.
Conclusions:
- Preoperative GRIT is linked to a significant reduction in POUR following PAHG urethral bulking.
- GRIT's mechanism involves conscious inhibition of the guarding reflex.
- Behavioral retraining via GRIT shows potential for integration with incontinence procedural therapies.
Related Concept Videos
01:26The Micturition Reflex
2.4K
Urination, or micturition involves the coordination of the bladder's detrusor muscle and two sphincters to ensure controlled bladder emptying.
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating...
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating...
2.4K
01:25Urinary Tract Calculi VI: Surgical Management
344
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
344
01:21Nursing Assessment of the Genitourinary System I: Health History
362
The genitourinary system is critical to maintaining fluid balance, waste elimination, and reproductive function. Nurses play a vital role in assessing this system, beginning with a thorough health history. This process involves gathering patient information, identifying risk factors, and recognizing symptoms of genitourinary disorders. Early detection is vital for timely interventions and management.1. Gathering Patient InformationA complete health history includes the patient’s personal,...
362
01:17Urinary Tract Infection IV: Nursing Management
414
In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs...
414
01:26Nursing Assessment of the Genitourinary System II: Inspection and Palpation
720
The nursing assessment of the genitourinary (GU) system involves a systematic inspection and palpation to identify abnormalities in the kidneys, bladder, and surrounding structures.InspectionMouth: Inspect for signs of kidney dysfunction, such as stomatitis (inflammation of the mouth) and ammonia breath, which may occur in advanced kidney disease due to the buildup of urea, breaking down into ammonia.Skin: Check for pallor, which could indicate anemia caused by kidney disease. Look for...
720
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
239
A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
239