Document Detail


Comparison of 2 techniques to predict voiding efficiency after inpatient urogynecologic surgery.
MedLine Citation:
PMID:  20727543     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: We compared 2 techniques used to assess adequate postoperative bladder emptying. MATERIALS AND METHODS: We performed a prospective, randomized, crossover study of 2 voiding trial techniques. 1) For back fill the bladder is filled with 300 cc saline before the Foley catheter is removed. 2) For auto fill the catheter is removed and the bladder is allowed to fill spontaneously. Patients were randomized into 2 groups for voiding trials, including group 1-auto fill followed by back fill or group 2-back fill followed by auto fill. Within 15 minutes of each void we measured post-void residual urine by straight catheterization. A void of two-thirds or greater of total bladder volume (voided volume plus post-void residual urine) at void 2 of the 2 voids was considered successful voiding. Patients who voided successfully were discharged home without a urethral catheter. We used the chi-square test with κ to determine successful bladder emptying. RESULTS: We recruited 79 patients, of whom 65 with a mean age of 59.7 years (range 33 to 81) had complete data sets available for analysis. Of the patients 38 (58%) underwent prolapse repair only, 1 (2%) underwent a continence procedure only and 26 (40%) underwent each procedure. The back fill void trial correlated better with a successful voiding trial than the auto fill trial (κ = 0.91, 95% CI 0.81-1.00 vs κ = 0.56, 95% CI 0.39-0.74). Overall 40.5% of patients had an unsuccessful void trial on day 1 postoperatively and were discharged home with a catheter. None subsequently experienced urinary retention. CONCLUSIONS: The back fill technique appears to be a better predictor of adequate postoperative bladder emptying than the auto fill technique for inpatient void trials.
Authors:
James Q Pulvino; Erin E Duecy; Gunhilde M Buchsbaum; Michael K Flynn
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2010-08-19
Journal Detail:
Title:  The Journal of urology     Volume:  184     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-13     Completed Date:  2010-10-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1408-12     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York, USA. jpulvin2@ohiohealth.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cross-Over Studies
Diagnostic Techniques, Urological
Gynecologic Surgical Procedures
Humans
Middle Aged
Pelvic Organ Prolapse / surgery*
Postoperative Care
Prospective Studies
Urinary Bladder / physiology*
Urinary Incontinence / surgery*
Urologic Surgical Procedures

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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