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Incidence and Risk Factors of Postoperative Urinary Retention in Gynecologic Surgery: A Systematic Review and
Anisa Hasanah1, Ida Maryati2, Ermiati Ermiati2
1Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, Indonesia.
Clinical Epidemiology
|April 17, 2026
Summary
Postoperative urinary retention (POUR) affects 16.1% of patients after gynecologic surgery. Incidence varies by procedure, with pelvic organ prolapse surgery posing the highest risk, necessitating tailored prevention strategies.
Area of Science:
- Gynecologic Surgery
- Urology
- Evidence-Based Medicine
Background:
- Postoperative urinary retention (POUR) is a common complication following gynecologic procedures.
- Reported incidence rates for POUR vary significantly due to procedural differences and inconsistent outcome definitions.
- A standardized quantitative synthesis was lacking for POUR incidence and risk factors.
Purpose of the Study:
- To determine the pooled incidence of POUR after gynecologic surgery.
- To identify risk factors associated with POUR.
- To summarize effective preventive strategies for POUR.
Main Methods:
- A systematic review and meta-analysis adhering to PRISMA guidelines.
- Searches conducted across PubMed, Scopus, EBSCO, and ScienceDirect databases.
- Random-effects models used for pooled incidence estimation, with subgroup analyses by surgical procedure and POUR definition.
Main Results:
- Analysis of 34 studies involving 20,466 patients.
- Pooled incidence of POUR was 16.1% (95% CI 12.8-20.1).
- Highest incidence observed after pelvic organ prolapse surgery (30.9%) and sling procedures (25.3%); lowest after minimally invasive hysterectomy (3.7%).
- Risk factors included voiding dysfunction, diabetes, vaginal approach, and opioid use; minimally invasive techniques and perioperative strategies showed protective effects.
Conclusions:
- Postoperative urinary retention is a frequent, procedure-dependent complication in gynecologic surgery.
- Risk stratification tailored to specific procedures is essential.
- Standardized perioperative pathways are recommended to mitigate POUR and enhance patient recovery.
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