Predictors of postoperative urinary retention after severe pelvic organ prolapse

Objective: To investigate the rate of postoperative urinary retention (POUR) and to identify factors associated with POUR of severe pelvic organ prolapse (POP). Methods: A retrospective chart review was conducted for 194 patients who were diagnosed with severe POP. Among them, 152 patients underwent total pelvic floor reconstruction and 42 patients underwent traditional vaginal hysterectomy and vaginal wall repair. POUR was defined as a need for the post-void residual urine volume was＞150mL who should be catheterization subsequent to the removal of the indwelling urethral catheter. Results: POUR was reported in 51 women (26.3%). The incidence of POUR was 28.3% of patients who underwent the total pelvic floor reconstruction. And was 19.0% after traditional vaginal hysterectomy and vaginal wall repair. Crude analysis revealed a significant association between the following variables and the risk of POUR: Aa, Ba, C by POP-Q exam, POP-Q staging, diabetes mellitus, Preoperative post-void residual volume (PVR) , bladder neck mobility, preoperative incontinence (P < 0.05) . POP-Q Staging (odds ratio, 4.79; 95% confidence interval, 1.025-22.383; P=0.046), PVR (odds ratio,1.054; 95% confidence interval, 1.03-1.079; P＜0.01), bladder neck mobility (odds ratio, 1.078; 95% confidence interval,1.021-1.138; P = 0.007) and complaint of incontinence (odds ratio, 2.686; 95% confidence interval,1.101-6.553; P = 0.03) were identified as the significant predictor of POUR In the logistic regression analysis. Conclusion: POP-Q staging, Preoperative post-void residual volume (PVR), bladder neck mobility and complaint of incontinence were significant predictors for POUR after severe pelvic organ prolapse surgery.