Urinary Retention Complications Following Pelvic Floor Reconstructive Surgery: Prevention and Management Strategies...

Area of Science:

• Urology
• Gynecology
• Evidence-Based Medicine

Background:

• Postoperative urinary retention (POUR) is a common complication following pelvic floor reconstruction.
• Standardized evidence-based guidelines are needed for POUR prevention and management.

Purpose of the Study:

• To systematically evaluate and summarize the best available evidence on preventing and managing POUR after pelvic floor reconstruction.
• To establish an evidence-based foundation for clinical practice.

Main Methods:

• A systematic search of domestic and international databases and websites was conducted.
• Evidence included clinical decisions, guidelines, systematic reviews, meta-analyses, and expert consensus.
• Twenty-one studies were included to develop 26 evidence-based recommendations.

Main Results:

• Preoperative evaluation should focus on urination status, postvoid residual (PVR), and risk factors, avoiding routine urodynamic testing.
• Intraoperative measures include minimizing urethral separation and ensuring tension-free slings/meshes.
• Catheter removal within 24-48 hours postoperatively, followed by voiding trials (retrograde recommended), is advised. Intermittent or indwelling catheterization is the primary treatment for POUR.

Conclusions:

• The 26 recommendations offer guidance for standardizing POUR management in pelvic floor reconstructive surgery.
• Healthcare professionals should adapt recommendations to specific clinical contexts for optimal patient outcomes.
• Future research should prioritize risk assessment tools and specific preventive measures for POUR in this patient population.