Repeat post-op voiding trials: an inconvenient correlate with success Journal Article

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Authors: Ferrante, K. L.; Kim, H. Y.; Brubaker, L; Wai, C. Y.; Norton, P. A.; Kraus, S. R.; Shepherd, J.; Sirls, L. T.; Nager, C. W.; Urinary Incontinence Treatment Network
Article Title: Repeat post-op voiding trials: an inconvenient correlate with success
Abstract: AIMS: This study examined the association between the need for a repeat voiding trial after midurethral sling (MUS) surgery and 1-year success rates. METHODS: We conducted this secondary analysis of the participants in the Urinary Incontinence Treatment Network trial of midurethral sling (TOMUS) study which compared retropubic versus transobturator MUS. A standard voiding trial was attempted on all subjects. The "repeat voiding trial" group included subjects discharged with catheterization. All others were considered "self voiding." Success rates between the groups at 1-year were compared, followed by multivariate analyses controlling for previously reported clinical predictors of success. RESULTS: Most women (76%) were self-voiding, while 24% required a repeat voiding trial. The objective success rate at 1-year was 85.8% in the repeat voiding trial group and 75.3% in the self-voiding group (P = 0.01). Subjective success rate at 1-year was 61.0% in the repeat voiding trial group and 55.1% in the self-voiding group (P = 0.23). Women in the repeat voiding trial group continued to demonstrate greater objective success than the self-voiding group in multivariate analysis that controlled for previous incontinence surgery, pad weight, urethral mobility, urge score, and type of MUS (P = 0.04, OR 1.82, 95% CI 1.03-3.22). CONCLUSIONS: Women who require a repeat voiding trial following MUS surgery have greater objective success at 1-year postoperatively when compared to those who are self-voiding at the time of discharge. These results may help reassure women who require catheterization after MUS surgery that their outcome is not compromised by this immediate transient post-operative result.
Journal Title: Neurourology and urodynamics
Volume: 33
Issue: 8
ISSN: 1520-6777; 0733-2467
Publisher: Wiley Periodicals, Inc  
Journal Place: United States
Date Published: 2014
Start Page: 1225
End Page: 1228
Language: eng
DOI/URL:

10.1002/nau.22489
Notes: LR: 20150425; CI: (c) 2013; GR: L60 MD000931/MD/NIMHD NIH HHS/United States; GR: U01 DK058225/DK/NIDDK NIH HHS/United States; GR: U01 DK058229/DK/NIDDK NIH HHS/United States; GR: U01 DK058231/DK/NIDDK NIH HHS/United States; GR: U01 DK060379/DK/NIDDK NIH HHS/United States; GR: U01 DK060380/DK/NIDDK NIH HHS/United States; GR: U01 DK060393/DK/NIDDK NIH HHS/United States; GR: U01 DK060395/DK/NIDDK NIH HHS/United States; GR: U01 DK060397/DK/NIDDK NIH HHS/United States; GR: U01 DK060401/DK/NIDDK NIH HHS/United States; JID: 8303326; NIHMS530956; OID: NLM: NIHMS530956; OID: NLM: PMC3937293; OTO: NOTNLM; 2013/05/23 [received]; 2013/07/31 [accepted]; 2013/08/27 [aheadofprint]; ppublish