Medical approach to urinary retention after vaginal hysterectomy

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

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Immediate Foley removal after laparoscopic and vaginal hysterectomy: Determinants of postoperative urinary retention

Journal of Minimally Invasive Gynecology ◽

10.1016/j.jmig.2007.06.013 ◽

2007 ◽

Vol 14 (6) ◽

pp. 706-711 ◽

Cited By ~ 32

Author(s):

Fabio Ghezzi ◽

Antonella Cromi ◽

Stefano Uccella ◽

Giacomo Colombo ◽

Stefano Salvatore ◽

...

Keyword(s):

Urinary Retention ◽

Vaginal Hysterectomy ◽

Postoperative Urinary Retention

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DISTIGMlNE BROMIDE (UBRETID) FOR THE PREVENTION OF URINARY RETENTION AFTER VAGINAL HYSTERECTOMY

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/j.1471-0528.1972.tb15812.x ◽

1972 ◽

Vol 79 (4) ◽

pp. 377-378 ◽

Cited By ~ 1

Author(s):

John Walsh ◽

John Bonnar

Keyword(s):

Urinary Retention ◽

Vaginal Hysterectomy

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Risk factors for urinary retention after vaginal hysterectomy for pelvic organ prolapse

Obstetrics & Gynecology Science ◽

10.5468/ogs.2016.59.2.137 ◽

2016 ◽

Vol 59 (2) ◽

pp. 137 ◽

Cited By ~ 12

Author(s):

Chul Chong ◽

Hye Sung Kim ◽

Dong Hoon Suh ◽

Byung Chul Jee

Keyword(s):

Risk Factors ◽

Pelvic Organ Prolapse ◽

Urinary Retention ◽

Vaginal Hysterectomy ◽

Pelvic Organ

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Intravesicular Prostaglandin E2 for the Prophylaxis of Urinary Retention after Colpohysterectomy

Journal of International Medical Research ◽

10.1177/030006059802600205 ◽

1998 ◽

Vol 26 (2) ◽

pp. 87-92 ◽

Cited By ~ 12

Author(s):

A Grignaffini ◽

F Bazzani ◽

P Bertoli ◽

M Petrelli ◽

E Vadora

Keyword(s):

Urinary Retention ◽

Vaginal Hysterectomy ◽

Genital Prolapse ◽

Treated Group ◽

Bladder Function ◽

Control Group ◽

Grade Ii ◽

Detrusor Function ◽

Group 2 ◽

Group 1

The aim of this study was to assess the efficacy of PGE2 in enhancing bladder function after vaginal hysterectomy. A total of 110 women with or without urinary incontinence underwent vaginal hysterectomy and cystourethropexy surgery because of grade II or III genital prolapse. Preoperatively the patients were randomly assigned to two groups: group 1 ( n = 50) received on the fourth post-operative day, before removal of the bladder catheter, an intravesicular solution of 1.50 mg PGE2 (2 × 0.75 mg); group 2 ( n = 60) did not receive any prophylaxis for urinary retention. In the PGE2-treated group significantly fewer patients had urinary retention for 3 days or more (10%, P < 0.05) than in the control group (27%). The use of intravesicular PGE2 reduced the time taken to restore detrusor function.

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Postoperative Urinary Retention in Total Vaginal and Abdominal Hysterectomy in Benign Gynecological Disorders

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v3i1.25 ◽

2016 ◽

Author(s):

Hertia Triarani ◽

Tyas Priyatini

Keyword(s):

Urinary Retention ◽

Vaginal Hysterectomy ◽

Analytical Study ◽

Urine Volume ◽

Abdominal Hysterectomy ◽

Research Subjects ◽

Postoperative Urinary Retention ◽

Gynecological Disorders ◽

Cohort Design ◽

Larger Sample

Objective: To assess and compare the incidence of urinary retention in patients post‐vaginal and abdominal total hysterectomy for benign gynecological disorders. Method: This is a comparative analytical study with prospective and retrospective cohort design, which was conducted in Dr. Cipto Mangunkusumo Hospital and Persahabatan Hospital from June 2012 to February 2014. Result: We recruited thirty‐eight research subjects who underwent abdominal hysterectomy, and 18 subjects who underwent vaginal hysterectomy. The majority of cases underwent the procedure for abnormal uterine myoma (55.5%) and adenomyosis (28.9%). Incidence of urinary retention post‐hysterectomy was 33.3% for vaginal hysterectomy, and 31.6% for abdominal hysterectomy. The comparison of the incidence of urinary retention showed no difference between vaginal and abdominal hysterectomies (RR=1.056). Conclusion: Vaginal hysterectomy does not increase the incidence of postoperative urinary retention. However, this study suggests the need for further research with a larger sample size, employing prospective cohort design, with preoperative measurement of postvoiding urine volume (PVR). Keywords: abdominal hysterectomy, urinary retention, vaginal hysterectomy

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A comparative study to assess the effect of intrathecal bupivacaine with morphine or butorphanol on post-operative pain relief following abdominal and vaginal hysterectomy

Health Renaissance ◽

10.3126/hren.v11i3.9640 ◽

2014 ◽

Vol 11 (3) ◽

pp. 246-249

Author(s):

SN Singh ◽

A Subedi ◽

JN Prasad ◽

MC Regmi

Keyword(s):

Postoperative Pain ◽

Pain Relief ◽

Urinary Retention ◽

Normal Saline ◽

Vaginal Hysterectomy ◽

Intrathecal Morphine ◽

Postoperative Pain Relief ◽

Sensory Level ◽

Post Operative Pain ◽

Group B

Background: Post-operative pain management can be challenging. Objectives: To compare the efficiency of morphine with that of butorphanol in controlling the postoperative pain relief. Methods: This double-blind randomized clinical trial was performed on 75 consecutive patients. Intrathecal 3ml hyperbaric bupivacaine mixed with morphine (200 microgm-0.25ml); or mixed with butorphanol (200 microgm-0.25ml); or mixed with normal saline 0.25ml was administered to alternate groups (25 patients in each group), for postoperative pain relief after abdominal and vaginal hysterectomy. They were monitored for pain relief in the recovery and gynaecological ward for 24 hours. If the patient had any complications like nausea, vomiting, itching and urinary retention were recorded. Results: Time for two segment regression of sensory level in patients receiving intrathecal morphine (Group-M), was 114.0±12.2 min., intrathecal butorphanol (Group- B) was 96.0+24.4 min and normal saline (Group- N) was 104.4 ± 18.5min. Duration of pain relief after subarachonoid block In Group-M was 492.0 ± 153.2min, in Group- B 311.20 ±58.7min and in Group-N it was 299.4 ± 72.7min. Two patients (8%) in Group-M had nausea, vomiting and itching but none in other groups. Urinary retention occurred in 3 patients (12%), in Group- M, whereas the same was found in 2 patients (8%) and 1 patient (4%) of Group-B and N respectively. Conclusion: Intrathecal morphine provided prolonged and better analgesic effect after abdominal and vaginal hysterectomy than butorphanol, though there were some side effects like nausea, vomiting, itching and urinary retention which were graded by the patients as clinically not significant. DOI: http://dx.doi.org/10.3126/hren.v11i3.9640 Health Renaissance 2013;11(3):246-249

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