Does spinal anesthesia lead to postoperative urinary retention in same-day urogynecology surgery? A retrospective review

Alexandriah Alas, Ryan Hidalgo, Luis Espaillat, Hemikaa Devakumar, G. Willy Davila, Eric Hurtado

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Introduction and hypothesis: Spinal anesthesia has been reported to be a risk factor for postoperative urinary retention (POUR) in various surgical specialties. We hypothesized that spinal anesthesia was a risk factor for POUR after outpatient vaginal surgery for pelvic organ prolapse (POP). Methods: This was a retrospective review of an urogynecology database for all outpatient POP vaginal surgeries performed in 2014 to evaluate the risk of POUR after general versus spinal anesthesia. A standardized voiding trial was performed by backfilling the bladder with 300 ml of saline. A successful trial was achieved if the patient voided two-thirds of the total volume instilled, confirmed by bladder ultrasound. Our primary outcome was to compare POUR requiring discharge with a Foley catheter between spinal and general anesthesia. Multivariate logistic regression was performed for variables with significance at p < 0.1 at the bivariate level. Results: A total of 177 procedures were included, 126 with general and 51 with spinal anesthesia. The overall POUR rate was 48.9%. Type of anesthesia was not a risk factor for POUR. Multivariate logistic regression demonstrated that age < 55 years (adjusted odds ratio [OR] 3.73; 95% confidence interval [CI], 1.31–11.7), diabetes (adjusted OR 4.18, 95% CI 1.04–21.67), and having a cystocele ≥ stage 2 (adjusted OR 4.23, 95% CI 1.89–10) were risk factors for developing POUR. Conclusions: Acute urinary retention after outpatient vaginal pelvic floor surgery can vary by procedure, but overall is 48.9%. Spinal anesthesia does not contribute to POUR, but rates are higher in those women that are younger than 55 years of age, have a cystocele ≥ stage 2 preoperatively, and a history of diabetes.

Original languageEnglish (US)
Pages (from-to)1283-1289
Number of pages7
JournalInternational Urogynecology Journal
Volume30
Issue number8
DOIs
StatePublished - Aug 1 2019

Keywords

  • Midurethral slings
  • Pelvic organ prolapse
  • Post-operative urinary retention
  • Spinal anesthesia

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Urology

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