Short summary

Post operative urinary retention is a commonly observed complication following women undergoing urogynecology surgery. Therefore, it is important to control that these patients are able to void prior to discharge. This can be done by various voiding trials. The overall aim of the study is to compare two postoperative voiding trials and to evaluate if one is superior to the other.

Rationale

Post operative voiding dysfunction is a common complication after urogynecology surgery. Incontinence and prolapse surgery have the highest rates of post operative urinary retention compared with other benign pelvic surgery. After urogynecology surgery, postoperative voiding dysfunction or incomplete voiding can lead to an increased residual volume. This may in some cases be followed by intermittent catheterization due to increased residual urine volume. Retention of urine may be followed by pain and the inability to void. Further, the patients are at risk of developing urinary tract infection as well as discomfort. Prolonged bladder distension can also lead to detrusor dysfunction and bladder malfunction. Therefore, in order to identify patients with postoperative urine retention early, it is important to control that these patients are able to void prior to discharge. The voiding function can be tested by various voiding trials. Some voiding trials follow strict protocols and others are very minimalistic. Strict voiding trials are often used as a tool in clinical trials including post voiding residual volume and voided volume. A minimalistic voiding trial demands the patient's ability to void and is poorly described in the literature. Replacing a strict protocol with a minimalistic voiding trial can be less time consuming for the patient and lower the work burden for the nurses. It might be helpful in the short and long term, as we expect that most patients can be discharged earlier and moreover decrease the risk of complications. At Odense University Hospital (OUH) where a strict voiding trial is used, the patient is discharged with a residual urine below 200 ml and a voiding volume above 150 ml.

​​The primary aim of this study is to evaluate time to discharge in two different voiding trials techniques (strict vs minimalistic) after anterior, posterior or vaginal vault prolapse surgery as well as bulking surgery. Secondly, to evaluate the frequency of postoperative urinary tract infection, urine retention and pain as well as patients' calls to the gynecological ward after discharge.

Data and biological material

Questionnaire data and data from the patients journal.

Collaborating researchers and departments

Department of Gynecology and Obstetrics, OUH

• Martin Rudnicki
• Ulla Darling Hansen