Impact of acute or chronic post-void retention after midurethral sling surgery for women with stress urinary incontinence: a systematic review and retrospective analysis of our data.

Abstract

Objectives: The aim of our study was to analyze the percentage of acute urinary retention after midurethral sling (MUS) surgery for stress urinary incontinence (SUI). The results of our study directed us to conduct a systemic review (SR) because of the need to consolidate existing knowledge on the incidence and management of postoperative urinary retention.

Design: The first part of the article presents the SR, which was conducted after the retrospective analyses of our data. Participants/Materials: This article presents a retrospective study conducted on a sample of 55 patients who underwent three different types of MUS surgery: TVT-Abbrevo, TVT-O, and single-incision Ophira Mini Sling.

Setting: The study analyzes outcomes at a median 8-year follow-up, focusing on the significance of acute urinary retention after MUS surgery.

Methods: SR was conducted using Medline, Cochrane, and Clinical Trials databases, following PRISMA guidelines. The retrospective study involved 55 patients who underwent three types of MUS surgery (TVT-Abbrevo, TVT-O, and Ophira) at our clinic, with a median follow-up of 8 years. Postoperative outcomes, including acute urinary retention and residual urine, were assessed using ultrasound, and success was evaluated through the Patient Global Impression of Improvement (PGI-I) and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF).

Results: The SR has shown that the reported percentage of patients with acute postoperative urinary retention after MUS procedures varies between 1.5% and 6.6%. In our retrospective analyses, five patients had acute urinary retention after the procedure (9.1%) and required the use of a Foley catheter for several days. All three surgical procedures resulted in similar levels of patient satisfaction at follow-up, as indicated by the PGI-I scores and patients' ICIQ-SF scores. The type of procedure and the patients' ICIQ-SF or PGI-I scores do not significantly correlate with the post-void residual volume.

Limitations: One of the major limitations in our analyses is the lack of any possibility to compare all TVT approaches, including retropubic. A larger sample size would be necessary to draw more definitive conclusions from these observations.

Conclusions: Our SR provides a comprehensive synthesis of previous research on urinary retention after MUS surgery. We noted that many studies fail to consider the possibility of preexisting urinary retention. Clinically significant long-term urinary retention in our cohort of patients was below 100 ml, was not specifically correlated with any type of procedure, and was not statistically correlated with acute urinary retention after operation.