Alexa Courtepatte1, Maura Kelly2, Vatche A Minassian2. 1. Division of Urogynecology, Department of OB/GYN, Mass General Brigham, 500 Brookline Ave, Suite E, Boston, MA, 02215, USA. acourtepatte@bwh.harvard.edu. 2. Division of Urogynecology, Department of OB/GYN, Mass General Brigham, 500 Brookline Ave, Suite E, Boston, MA, 02215, USA.
Abstract
INTRODUCTION AND HYPOTHESIS: This study aims to determine whether the use of preoperative transdermal scopolamine is associated with an increased risk of postoperative urinary retention in urogynecologic surgeries. METHODS: This is a retrospective chart review study of women who underwent surgery between January 1, 2018, and December 31, 2020. Patients who received a scopolamine patch versus those who did not were compared using demographic and perioperative variables utilizing Pearson's chi-squared test and t-test of Wilcoxon rank-sum. A logistic regression was performed to evaluate the effect of scopolamine on the patients' postoperative voiding trial results, controlling for confounders. P-value < 0.05 was considered statistically significant. RESULTS: A total of 449 women underwent a vaginal or laparoscopic hysterectomy, midurethral sling placement, uterosacral or sacrospinous ligament suspension, sacrocolpopexy, anterior/posterior colporrhaphy, or other urogynecologic surgeries with 109 (24.2%) having received transdermal scopolamine. A significantly higher number of women with preoperative scopolamine [n = 50 (45.9%)] failed their voiding trial compared to those without scopolamine [n = 100 (29.4%), p = 0.0016]. The adjusted model yielded an odds ratio of 1.75 (95% CI: 1.08-2.85) of a failed voiding trial in the scopolamine group. When comparing the odds of failing voiding trial by surgery type, those with a midurethral sling placed during surgery had an adjusted odds ratio of 3.12 (95% CI: 2.01-4.87), as compared to those without a midurethral sling. CONCLUSIONS: Use of a transdermal scopolamine patch for nausea and vomiting prophylaxis is associated with increased risk of postoperative urinary retention across all urogynecologic surgeries.
INTRODUCTION AND HYPOTHESIS: This study aims to determine whether the use of preoperative transdermal scopolamine is associated with an increased risk of postoperative urinary retention in urogynecologic surgeries. METHODS: This is a retrospective chart review study of women who underwent surgery between January 1, 2018, and December 31, 2020. Patients who received a scopolamine patch versus those who did not were compared using demographic and perioperative variables utilizing Pearson's chi-squared test and t-test of Wilcoxon rank-sum. A logistic regression was performed to evaluate the effect of scopolamine on the patients' postoperative voiding trial results, controlling for confounders. P-value < 0.05 was considered statistically significant. RESULTS: A total of 449 women underwent a vaginal or laparoscopic hysterectomy, midurethral sling placement, uterosacral or sacrospinous ligament suspension, sacrocolpopexy, anterior/posterior colporrhaphy, or other urogynecologic surgeries with 109 (24.2%) having received transdermal scopolamine. A significantly higher number of women with preoperative scopolamine [n = 50 (45.9%)] failed their voiding trial compared to those without scopolamine [n = 100 (29.4%), p = 0.0016]. The adjusted model yielded an odds ratio of 1.75 (95% CI: 1.08-2.85) of a failed voiding trial in the scopolamine group. When comparing the odds of failing voiding trial by surgery type, those with a midurethral sling placed during surgery had an adjusted odds ratio of 3.12 (95% CI: 2.01-4.87), as compared to those without a midurethral sling. CONCLUSIONS: Use of a transdermal scopolamine patch for nausea and vomiting prophylaxis is associated with increased risk of postoperative urinary retention across all urogynecologic surgeries.
Authors: G Nelson; A D Altman; A Nick; L A Meyer; P T Ramirez; C Achtari; J Antrobus; J Huang; M Scott; L Wijk; N Acheson; O Ljungqvist; S C Dowdy Journal: Gynecol Oncol Date: 2015-11-18 Impact factor: 5.482
Authors: Matthew D Barber; Arlan Marcus Gustilo-Ashby; Chi Chiung Grace Chen; Petek Kaplan; Marie Fidela R Paraiso; Mark D Walters Journal: Am J Obstet Gynecol Date: 2006-10-05 Impact factor: 8.661
Authors: María A Antor; Alberto A Uribe; Natali Erminy-Falcon; Joseph G Werner; Keith A Candiotti; Joseph V Pergolizzi; Sergio D Bergese Journal: Front Pharmacol Date: 2014-04-09 Impact factor: 5.810
Authors: Sanjay Saint; Barbara W Trautner; Karen E Fowler; John Colozzi; David Ratz; Erica Lescinskas; John M Hollingsworth; Sarah L Krein Journal: JAMA Intern Med Date: 2018-08-01 Impact factor: 21.873