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Park, Kwon, Park, Moon, Kim, and Bai: Predicting risk factors of postoperative voiding dysfunction after abdominal sacrocolpopexy in the treatment of pelvic organ prolapse
Original Article
Korean Journal of Obstetrics & Gynecology

Korean Journal of Obstetrics & Gynecology 2011; 54(2): 93-98.

Published online: 16 February 2011

DOI: https://doi.org/10.5468/KJOG.2011.54.2.93

Predicting risk factors of postoperative voiding dysfunction after abdominal sacrocolpopexy in the treatment of pelvic organ prolapse

Su Yeon Park, MD, Ha Yan Kwon, MD, Jung Hwa Park, MD, Yeo Jung Moon, MD, Sei Kwang Kim, MD, Sang Wook Bai, MD

Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea.

Corresponding author: Sang Wook Bai, MD. Department of Obstetrics and Gynecology, Yonsei University College of Medicine, 134 Haengdang-dong, Seodaemun-gu, Seoul 120-752, Korea. Tel: +82-2-2228-2241, Fax: +82-2-313-8357, swbai@yuhs.ac

Received 1 December 2010       Accepted 31 January 2011

Copyright © 2011. Korean Society of Obstetrics and Gynecology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

Although there were many studies about postoperative voiding dysfunction after anti-incontinence operation, little studies after pelvic organ prolapse operation were published. We sought to determine risk factors for voiding dysfunction (VD) after abdominal sacrocolpopexy (ASC).

Methods

ASC was performed on 89 women at Yonsei University Health System from January 2007 to December 2009. VD was defined as post void residual (PVR)>150 mL. Foley catheter was removed after the third or forth postoperative day (POD). Risk factors for VD were examined using logistic regression models.

Results

Seventeen patients (19.1%) had VD. Total abdominal hysterectomy (TAH) was performed on 70.8%, transobturator tape (TOT) on 55.1% concomitantly. There was no significant difference in age (mean±standard deviation [SD], 59.9±12.8 vs. 62.7±8.1 yr), parity (mean [range], 3 [1-5] vs. 3 [1-8]), body mass index (mean±SD, 24.0±2.7 vs. 24.4±3.6), TAH (70.6% vs. 70.8%), TOT (52.9% vs. 55.6%) and pelvic organ prolapse quantification stage 4 (94.1% vs. 68.1%, P-value 0.057). There was significant difference in diabetes mellitus (29.4% vs. 9.7%, odds rations [OR]: 3.87 [95% confidence intervals, CI: 1.05-14.23]) and the day of foley removal (POD 4: 47.1% vs. 13.9%, OR: 5.51 [95% CI: 1.72-17.64]). There was no significant difference in urodynamic parameters including maximal capacity, urethral closure pressure, maximal flow rate, mean flow rate, post void residual except detrusor pressure at maximal flow rate (Pdet at Qmax), (13±8 vs. 23±15, per 10 cm H20, OR 0.54 [95% CI: 0.31-0.95]). In the multiple logistic regression model, only Pdet at Qmax OR 0.94 (95% CI: 0.89-0.99) remained statistically significant.

Conclusion

Women with lower Pdet at Qmax are more likely to have VD after ASC.

Keywords: Pelvic organ prolapse, Abdominal sacrocolpopexy, Voiding dysfunction, Urodynamics

Figures and Tables

Table 1
Demographic, surgical and preoperative characteristics
kjog-54-93-i001

Data presented as n (%) or mean±standard deviation (SD).

VD, voding dysfunction; OR, odds ratio; CI, confidence interval; BMI, body mass index; HTN, hypertension; DM, diabetes mellitus; ds, disease; Preop, preoperative; Sx, symptom; TAH, total abdominal hysterectomy; TOT, transobturator tape; POD, postoperative day.

Table 2
Preoperative urodynamics and uroflowmetry parameters
kjog-54-93-i002

Data presented as mean±standard deviation (SD).

VD, voding dysfunction; OR, odds ratio; CI, confidence interval; MCC, maximum cystometric capacity; MUCP, maximum urethral closure pressure; PVR, postvoid residual; Pdet at Qmax, detrusor pressure at maximal flow rate.

Table 3
Multivariable logistic regression model for risk factors of postoperative voiding dysfunction
kjog-54-93-i003

OR, odds ratio; CI, confidence interval; DM, diabetes mellitus; POD, postoperative day.

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