Risk factors for postoperative urinary retention following pelvic organ prolapse surgery: a meta-analysis

Postoperative urinary retention (POUR) is one of the most common problems following pelvic organ prolapse (POP) surgery, the risk factors associated with its occurrence have been reported inconsistently across studies. We aim to synthesize the risk factors of urinary retention after POP surgery using a meta-analysis approach. Databases of the PubMed, The Cochrane Library, EMBASE, Web of Science, CBM, CNKI, WanFang and VIP were systematically searched through December 31, 2024. A total of 2065 studies were identified, 19 of which were included in this meta-analysis and 14 risk factors were analyzed. older age (OR = 1.03, 95% CI [1.01, 1.06], P = 0.01), age ≥ 60 years (OR = 1.29, 95% CI [1.05, 1.59], P = 0.01) and being menopausal (OR = 1.44, 95% CI [1.10, 1.88], P = 0.01), severe cystocele (OR = 3.15, 95% CI [1.92, 5.16], P < 0.01), preoperative post-void residual (PVR) > 200 mL(OR = 2.34, 95% CI [1.46, 3.76], P < 0.01), procedure time(OR = 1.11, 95% CI[1.04, 1.18], P < 0.01), anterior repair (OR = 1.97, 95% CI [1.55, 2.51], P < 0.01), anti-incontinence procedures (OR = 2.15, 95% CI [1.40, 3.28], P < 0.01), and hysterectomy (OR = 1.40, 95% CI [1.13, 1.75], P < 0.01) were associated with an increased risk of POUR. These findings aid in the preoperative identification of patients at high risk for POUR, enabling optimization of preoperative education strategies, guiding surgical decision-making and POUR prevention.