Risk factors for voiding dysfunction following midurethral sling operations

Abstract

We aimed to identify risk factors for postoperative voiding dysfunction following tension-free vaginal tape (TVT) or trans obturator tape (TOT). A retrospective case-control study was conducted on patients who underwent mid-urethral sling procedures over a four-year- period by the same surgical team. The patients were divided into two groups. Patients who needed to loosen the tape materials surgically before being discharged due to persistent postvoid residual bladder volume ≥150 ml and/or difficulty in emptying the bladder were described as postoperative voiding dysfunction (case group). The patients who did not need it were the control group. Demographic information, voiding symptoms, urodynamic evaluation, and intraoperative data were collected from the hospital's medical records. Of 167 patients, 29 (17.4%) were in the case group and 138 (82.6%) were in the control group. At univariate analysis, age, menopausal status, preoperative valsalva leak point pressure measurement, presence of preoperative ≥ grade 3 pelvic organ prolapse, TVT procedure, concomitant anterior colporrhaphy, and vaginal hysterectomy were associated with voiding dysfunction. Multivariate logistic regression revealed that menopausal status, TVT procedure, and concomitant anterior colporrhaphy were significant predictors of postoperative voiding dysfunction.The present study indicated that postoperative voiding dysfunction is more often after TVT than after TOT procedures. Menopausal status and concomitant anterior colporrhaphy increased the risk of postoperative voiding dysfunction. Recognition of these risk factors may enable surgeons to minimize this complication.

Keywords

• postoperative complication
• TOT
• TVT
• Voiding dysfunction

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