Short term catheter management options for urinary retention following pelvic surgery: a cost analysis

2021 ◽  
Author(s):  
Rui Wang ◽  
Elena Tunitsky-Bitton
Keyword(s):  
Cost Analysis ◽  
Urinary Retention ◽  
Pelvic Surgery ◽  
Short Term ◽  
Management Options

scholarly journals A Risk Calculator for Post-Operative Urinary Retention (POUR) Following Vaginal Pelvic Floor Surgery: Multivariable Prediction Modelling

2022 ◽  
Author(s):  
Breffini Anglim ◽  
George Tomlinson ◽  
Joalee Paquette ◽  
Colleen McDermott
Keyword(s):  
Pelvic Floor ◽  
Urinary Retention ◽  
Pelvic Surgery ◽  
Risk Calculator ◽  
Management Options ◽  
Data Set ◽  
Pelvic Floor Surgery ◽  
Estimated Blood Loss ◽  
Increased Risk ◽  
Prediction Modelling

Objective: To determine the peri-operative characteristics associated with an increased risk of post-operative urinary retention (POUR) following vaginal pelvic floor surgery. Design: A retrospective cohort study using multivariable prediction modelling. Setting: A tertiary referral urogynaecology unit. Population: Patients undergoing vaginal pelvic floor surgery from January 2015 to February 2020. Methods: Eighteen variables (24 parameters) were compared between those with and without POUR and then included as potential predictors in statistical models to predict POUR. The final model was chosen as the one with the largest c-index from internal cross-validation. This was then externally validated using a separate data set (n=94) from another surgical centre. Main Outcome Measures: diagnosis of POUR following surgery while the patient was in hospital. Results: Among the 700 women undergoing surgery, 301 (43%) experienced POUR. Pre-operative variables with statistically significant univariate relationships with POUR included age, menopausal status, prolapse stage, and uroflow parameters. Significant peri-operative factors included estimated blood loss, amount of intravenous fluid administered, operative time, length of stay, and specific procedures including vaginal hysterectomy with intraperitoneal vault suspension, anterior colporrhaphy, posterior colporrhaphy, and colpocleisis. The lasso logistic regression model had the best combination of internally cross-validated c-index (0.73) and accurate calibration curve. Using this data, a POUR risk calculator was developed (https://pourrisk.shinyapps.io/POUR/). Conclusions: This POUR risk calculator will allow physicians to counsel patients pre-operatively on their risk of developing POUR after vaginal pelvic surgery and help focus discussion around potential management options.

scholarly journals Complications Associated with Oocyte Retrieval: An Unusual Case of Hematuria and Recurrent Urinary Retention

2019 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Urinary Retention ◽  
Ovarian Hyperstimulation Syndrome ◽  
Acute Urinary Retention ◽  
Unusual Case ◽  
Urinary Catheter ◽  
Oocyte Retrieval ◽  
Ovarian Hyperstimulation ◽  
Management Options ◽  
Bladder Irrigation ◽  
Blood Clots

Background: Complications associated with oocyte retrieval include ovarian hyperstimulation syndrome, ovarian torsion, infection, bleeding, and even acute urinary retention. Case: A 29 year old female presented to the emergency department for dizziness and syncope following oocyte retrieval and was admitted for ovarian hyperstimulation syndrome. Her urinary catheter was obstructed by blood clots and relieved with bladder irrigated. The catheter was removed after twenty-four hours, and she was able to void spontaneously. Four days after discharge, she returned for urinary retention. She underwent cystoscopy and 10cc of blood clots was evacuated. The bladder appeared normal without intravesicular bleeding, and she was discharged home. Twelve hours later, the patient returned for urinary retention. Another cystoscopy was performed and 150cc of blood clots was evacuation. Her symptoms resolved. Conclusion: Hematuria and urinary retention are rare but serious complications of oocyte retrieval. Management options include a urinary catheter, bladder irrigation, urologic imaging, and cystoscopy

An Artificial Neural Network in Short-Term Electrical Load Forecasting of a University Campus: A Case Study

2013 ◽  
Vol 135 (3) ◽  
Author(s):  
David Palchak ◽  
Siddharth Suryanarayanan ◽  
Daniel Zimmerle
Keyword(s):  
Neural Network ◽  
Artificial Neural Network ◽  
Energy Consumption ◽  
Time Of Day ◽  
University Campus ◽  
Electrical Load ◽  
Ann Model ◽  
Short Term ◽  
Management Options ◽  
Artificial Neural

This paper presents an artificial neural network (ANN) for forecasting the short-term electrical load of a university campus using real historical data from Colorado State University. A spatio-temporal ANN model with multiple weather variables as well as time identifiers, such as day of week and time of day, are used as inputs to the network presented. The choice of the number of hidden neurons in the network is made using statistical information and taking into account the point of diminishing returns. The performance of this ANN is quantified using three error metrics: the mean average percent error; the error in the ability to predict the occurrence of the daily peak hour; and the difference in electrical energy consumption between the predicted and the actual values in a 24-h period. These error measures provide a good indication of the constraints and applicability of these predictions. In the presence of some enabling technologies such as energy storage, rescheduling of noncritical loads, and availability of time of use (ToU) pricing, the possible demand-side management options that could stem from an accurate prediction of energy consumption of a campus include the identification of anomalous events as well the management of usage.

scholarly journals PUK10 A COST ANALYSIS OF ALFUZOSIN IN THE MANAGEMENT OF ACUTE URINARY RETENTION

2003 ◽  
Vol 6 (6) ◽  
pp. 702-703
Author(s):  
M Lamotte ◽  
K Massaer ◽  
K Vranckx ◽  
L Annemans
Keyword(s):  
Cost Analysis ◽  
Urinary Retention ◽  
Acute Urinary Retention

scholarly journals A randomized controlled trial comparing short-term versus long-term catheterization after vaginal prolapse surgery

1970 ◽  
Vol 2 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Nupur Thakur ◽  
Geeta Gurung ◽  
Ashma Rana
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Retention ◽  
Vaginal Hysterectomy ◽  
Residual Volume ◽  
Short Term ◽  
Group 2 ◽  
Group 1

Aim: To determine whether short term bladder catheterisation for 24 hrs after vaginal hysterectomy for prolapse would be more advantageous to routinely practiced 3 days catheterisation. Method: Randomized comparative study was done as thesis topic in Gynaecological Ward of TU Teaching Hospital, Maharajgunj, Kathmandu from 30th October 2004 to 2nd November 2005. A total of 100 women were included in this study. Prior to surgery at OT table, and before giving prophylactic antibiotics urine samples were collected from metal catheter for routine analysis. They were randomized into two groups. In groups 1 (n=50) transurethral catheter was removed after 24 hrs of surgery. In group 2 (n=50) catheter was removed on 3rd post operative day. Urine culture was taken before removal of the catheter. Residual volume of urine after the first voiding was measured by transabdominal ultrasound. Recatheterisation for three more days was considered whenever residual volume exceeded 200ml. Result: Recatheterisation was not needed in either groups for residual volume >200ml. Regarding recatheterisation 4 needed them after 2-3 hrs of first voiding. Among these 4 women, cause of urinary retention was accountable for pelvic haematoma leading to pelvic abscess in one case, which belonged to group 1 where as urinary tract infection was responsible for urinary retention in group 2. There were no explainable causes in two cases. But urinary tract infection was seen in two cases in group 1 and 11 cases in group 2 (P value 0.017). Conclusion: This study has shown that short term catheterisation is more beneficial in terms of lower incidence of urinary tract infection (2 Vs 11) and related febrile morbidity as compared to long term catheterisation. Key words: Uterovaginal prolapse, pelvic floor repair with vaginal hysterectomy, catheterisation.   doi:10.3126/njog.v2i1.1473 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 29 - 34 May -June 2007

scholarly journals SHORT-TERM MEASURES TO AVOID RETALIATORY KILLING OF A TAPIR (Tapirus bairdii ) DURING A CASE OF HUMAN CONFLICT AT LA AMISTAD BIOSPHERE RESERVE, COSTA RICA

2020 ◽  
Vol 10 (1) ◽  
pp. 52
Author(s):  
Diego A. Gómez-Hoyos ◽  
Rocío Seisdedos-de-Vergara ◽  
Fernando Castañeda ◽  
Jan Schipper ◽  
Ronit Amit ◽  
...  
Keyword(s):  
Costa Rica ◽  
Biosphere Reserve ◽  
Crop Raiding ◽  
Short Term ◽  
Management Options ◽  
Research Priority ◽  
La Amistad Biosphere Reserve ◽  
Salt Lick ◽  
Human Conflict ◽  
Alternative Solutions

AbstractThe increase in human tapir conflict and lack of management options is worrying and has been identified as a research priority in previous conservation planning reviews for the group. Crop-raiding by Baird’s tapir was reported on a private farm within the La Amistad Biosphere Reserve, Costa Rica. We conducted an open interview with the owner and baited the tapir out of the damaged area using an artificial salt-lick. The measures taken (quick response, assistance on alternative solutions, and the decision to use of salt-licks) were successful short-term measures to avoid lethal retaliatory control of tapirs.Key words: conservation, crop-raiding, hunting, interview, salt-lick, tapir.ResumenEl aumento en los conflictos humano-tapir y la falta de opciones de manejo es preocupante, por lo que han sido identificados como una prioridad de investigación en revisiones previas de planeación para la conservación del grupo. En una finca privada ubicada dentro de la Reserva de la Biósfera La Amistad, Costa Rica, se reportó el daño a cultivos de un tapir centroamericano. Se realizó una entrevista abierta con el propietario y se atrajo al tapir fuera del área afectada usando un saladero artificial. Las medidas a corto plazo tomadas (respuesta rápida, asistencia en soluciones alternativas y la decisión del uso de saladeros) al parecer fueron exitosas para evitar el control letal retaliativo de tapires.Palabras clave: asalto de cultivos, cacería, conservación, entrevistas, saladeros, tapir.

Options for Low Rectal Cancer: Robotic Total Mesorectal Excision

2021 ◽  
Vol 34 (05) ◽  
pp. 311-316
Author(s):  
Felipe F. Quezada-Diaz ◽  
J. Joshua Smith
Keyword(s):  
Rectal Cancer ◽  
Three Dimensional ◽  
Pelvic Surgery ◽  
Nerve Sparing ◽  
Rectal Cancer Surgery ◽  
Distal Margin ◽  
Open Approach ◽  
Mesorectal Excision ◽  
Short Term ◽  
Conversion Rates

AbstractLow rectal cancers (LRCs) may offer a difficult technical challenge even to experienced colorectal surgeons. Although laparoscopic surgery offers a superior exposure of the pelvis when compared with open approach, its role in rectal cancer surgery has been controversial. Robotic platforms are well suited for difficult pelvic surgery due to its three-dimensional visualization, degree of articulation of instruments, precise movements, and better ergonomics. The robot may be suitable especially in the anatomically narrow pelvis such as in male and obese patients. Meticulous dissection in critical steps, such as splenic flexure takedown, nerve-sparing mesorectal excision, and distal margin clearance, are potential technical advantages. In addition, robotic rectal resections are associated with lower conversion rates to open surgery, less blood loss, and shorter learning curve with similar short-term quality of life outcomes, similar rates of postoperative complications, and equivalent short-term surrogate outcomes compared with conventional laparoscopy. Robotic surgery approach, if used correctly, can enhance the skills and the capabilities of the well-trained surgeon during minimally invasive procedures for LRC.

Perioperative use of tamsulosin significantly decreases rates of urinary retention in men undergoing pelvic surgery

2015 ◽  
Vol 30 (9) ◽  
pp. 1223-1228 ◽  
Author(s):  
Vitaliy Poylin ◽  
Thomas Curran ◽  
Thomas Cataldo ◽  
Deborah Nagle
Keyword(s):  
Urinary Retention ◽  
Pelvic Surgery

Management of Bladder Function after Outpatient Surgery 

1999 ◽  
Vol 91 (1) ◽  
pp. 42-50 ◽  
Author(s):  
Janet D. Pavlin ◽  
Edward G. Pavlin ◽  
Dermot R. Fitzgibbon ◽  
Meagan E. Koerschgen ◽  
Terryn M. Plitt
Keyword(s):  
High Risk ◽  
Urinary Retention ◽  
Outpatient Surgery ◽  
Treatment Algorithm ◽  
Low Risk ◽  
Bladder Function ◽  
Pelvic Surgery ◽  
Gynecologic Surgery ◽  
High Risk Patients ◽  
Risk Patients

Background This study was designed to test a treatment algorithm for management of bladder function after outpatient general or local anesthesia. Methods Three hundred twenty-four outpatients, stratified into risk categories for urinary retention, were studied. Patients in category 1 were low-risk patients (n = 227) having non-pelvic surgery and randomly assigned to receive 10 ml/kg or 2 ml/kg of intravenous fluid intraoperatively. They were discharged when otherwise ready, without being required to void. Patients in category 2 (n = 40), also presumed to be low risk, had gynecologic surgery. High-risk patients included 31 patients having hernia or anal surgery (category 3), and 31 patients with a history of retention (category 4). Bladder volumes were monitored by ultrasound in those in categories 2-4, and patients were required to void (or be catheterized) before discharge. The incidence of retention and urinary tract symptoms after surgery were determined for all categories. Result Urinary retention affected 0.5% of category 1 patients and none of category 2 patients. Median time to void after discharge was 75 min (interquartile range 120) in category 1 patients (n = 27) discharged without voiding. Fluids administered did not alter incidence of retention or time to void. Retention occurred in 5% of high-risk patients before discharge and recurred in 25% after discharge. Conclusion In reliable patients at low risk for retention, voiding before discharge appears unnecessary. In high-risk patients, continued observation until the bladder is emptied is indicated to avoid prolonged overdistention of the bladder.

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