R N Smith1, L Cardozo. 1. Department of Obstetrics & Gynaecology, King's College Hospital, London, UK.
Abstract
OBJECTIVE: To determine the incidence of post-operative voiding dysfunction (POVD) after colposuspension and to identify pre-operative risk factors. PATIENTS AND METHODS: A retrospective study of 100 women having colposuspension to determine the preoperative clinical assessment (history, physical examination, symptom-specific questionnaire and visual analogue score assessment of urological symptoms), pre-operative urodynamic investigations (uroflowmetry, twin-channel subtracted cystometry and video-cystourethrography), information on post-operative catheter management and the presence and management of any POVD. RESULTS: Twenty-one women experienced significant POVD attributable to their colposuspension. This resolved within 6 months in 19, but persisted beyond 6 months in two. Women experiencing POVD were significantly older and were more likely to have previously undergone a hysterectomy. The risk of POVD was 12% for those aged < 50 years, 25% at age 50-64, and 50% for those over 65 years. The duration of post-operative catheterization was related to the presence of symptoms of voiding difficulty. CONCLUSIONS: The risk of POVD after colposuspension increases with age. In women over 65 years old, consideration should be given to an elective temporary discharge home with a suprapubic catheter in situ for 7-10 days before initiating a catheter-clamping regimen.
OBJECTIVE: To determine the incidence of post-operative voiding dysfunction (POVD) after colposuspension and to identify pre-operative risk factors. PATIENTS AND METHODS: A retrospective study of 100 women having colposuspension to determine the preoperative clinical assessment (history, physical examination, symptom-specific questionnaire and visual analogue score assessment of urological symptoms), pre-operative urodynamic investigations (uroflowmetry, twin-channel subtracted cystometry and video-cystourethrography), information on post-operative catheter management and the presence and management of any POVD. RESULTS: Twenty-one women experienced significant POVD attributable to their colposuspension. This resolved within 6 months in 19, but persisted beyond 6 months in two. Women experiencing POVD were significantly older and were more likely to have previously undergone a hysterectomy. The risk of POVD was 12% for those aged < 50 years, 25% at age 50-64, and 50% for those over 65 years. The duration of post-operative catheterization was related to the presence of symptoms of voiding difficulty. CONCLUSIONS: The risk of POVD after colposuspension increases with age. In women over 65 years old, consideration should be given to an elective temporary discharge home with a suprapubic catheter in situ for 7-10 days before initiating a catheter-clamping regimen.
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