A Simple Protocol for Managing Post-Operative Urinary Retention (POUR): An Experience and Evidence

Edy Fakhrizal; Sri Wahyu Maryuni; Hamka Koerslo; Dhini Aiyulie Novri; Dika Putra Yuda

doi:10.37287/ijghr.v6i6.4021

Edy Fakhrizal Universitas Riau & RSUD Arifin Achmad
Sri Wahyu Maryuni Universitas Riau & RSUD Arifin Achmad
Hamka Koerslo Universitas Riau & RSUD Arifin Achmad
Dhini Aiyulie Novri Universitas Riau & RSUD Arifin Achmad
Dika Putra Yuda Universitas Riau & RSUD Arifin Achmad

DOI: https://doi.org/10.37287/ijghr.v6i6.4021

Keywords: patients, postoperative voiding management, post-operative urinary retention

Abstract

Proposing a simple protocol in the management of urinary retention in postoperative patients that can provide promising results. Methods: We analyzed women who underwent pelvic organ prolapse surgery for 6 years from January 2018 to July 2023. The incidence of postoperative urinary retention was identified and we implemented a simple protocol and assessed its success rate.Result : There were 503 surgeries due to POP incidence in Arifin Achmad General Hospital, Riau Province - Indonesia for 6 years. One hundred sixteen cases (23 %) experienced POUR, with mean first residual urine was about 393 ml (110–1.200 ml). The protocol was applied, and 81 % cases revealed satisfying results. In successful group, the patients were discharged after 4±1 days. There were significant differences in the first residual urine between patients who were successfully treated with the simple protocol (350±227 ml) and patients requiring physiotherapy consultation (576±325 ml), with p = 0.005. Conclusion: Most cases of postoperative urinary retention can be managed using this protocol. So this protocol can be considered to be applied.

References

Bodker B, Lose G. Postoperative urinary retention in gynecologic patients. Int Urogynecol J. 14, 94-7 (2003)

Vijjeswarapu, A. P., Londhe, V., Gowri, M., Kekre, A. & Kekre, N. Prevalence and clinical predictors for early post-operative urinary retention in patients undergoing pelvic reconstructive surgeries: a prospective cohort study. Int. J. Reprod. Contraception, Obstet. Gynecol. 7, 1452 (2018).

Asumpinwong C, Leerasiri P, Lomthong P, Hengrasmee P. Incidence and risk factors of urinary retention after vaginal hysterectomy for pelvic organ prolaps. Thai Journal of Obstetrics and Gynaecology. 29,281-287 (2021).

Wu JM, Mattheus CA, Conover MM, Pate V, Funk MJ. Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. American college of Obstetricians and Gynecologist. 123, 1201-1206 (2014)

Priyatini, T. & Sari, J. M. Incidence of postoperative urinary retention after pelvic organ prolapse surgery in Cipto Mangunkusumo National General Hospital. 23, 218–222 (2014).

Geller, E. J. Prevention and management of postoperative urinary retention after urogynecologic surgery. 829–838 (2014).

Alas A, Hidalgo R, Espaillat L, Devakumar H, Davila GW, Hurtado E. Does spinal anesthesia lead to postoperative urinary retention in same-day urogynecology surgery? A retrospective review. Int Urogynecol J. (2019)

Chong, C., Kim, H. S., Suh, D. H. & Jee, B. C. Risk factors for urinary retention after vaginal hysterectomy for pelvic organ prolapse. Obstet. Gynecol. Sci. 59, 137 (2016).

Baldini G, Bagry H, Aprikian A, Carli F. Postoperative urinary retention: anesthetic and perioperative considerations. Anesthesiology. 2009;110(5):1139-57.

Agrawal K, Majhi S, Garg R. Post operative urinary retention : review of literature.World J Anesthesiol.8, 1-12 (2019.

Trowbridge ER, Dreisbach CN, Sarosiek BM, Dunbar CP, Evans SL, Hahn LE, Hullfish KL. Review of enhanced recovery programs in benign gynecologic surgery. Int Urogynecol J. (2017).

Li ALK, Zajichek A, Kattan MW, Ji XK, Lo KA, Lee PE. Nomogram to predict risk of postoperative urinary retention in women undergoing pelvic reconstructive surgery. JOGC. 1203-1210 (2020)