Postoperative Management of Bladder Perforation During Mid-Urethral Sling Procedures.

IF 1.8 3区 医学 Q3 OBSTETRICS & GYNECOLOGY
Emir Gurbuz, E Cansu Cevik, Savci Bekir Telek, Oz Harmanli
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引用次数: 0

Abstract

Introduction and hypothesis: There is no clear consensus on managing bladder perforation after mid-urethral sling placement. Traditional use of an indwelling catheter can be frustrating. This study evaluates the difference in fistula rates between patients managed with and without continuous bladder drainage.

Methods: A retrospective chart review of women who underwent mid-urethral sling procedures in an academic center between the years 2017 and 2023 was completed. All cases of bladder perforation detected upon intraoperative cystoscopy were included in this cohort. Patient information, including demographics, clinical data, and perioperative factors, including operation type and postoperative catheter use, were extracted from electronic medical records. Descriptive statistics were performed.

Results: Out of a total of 1702 women who underwent mid-urethral sling procedures, 97 had bladder perforations confirmed by cystoscopy. Of these, 96 had retropubic slings, and 1 had a transobturator sling. There were 67 patients who also had concomitant pelvic organ prolapse repair, whereas 30 patients did not have any concomitant procedures. Of the cohort, 61 patients were discharged on the same day as the surgery without a catheter, whereas 36 had continuous bladder drainage with an indwelling catheter postoperatively. None of the patients developed fistulas in our study cohort. Postoperative adverse outcomes, including recurrent urinary tract infection, mesh exposure, and urinary retention were similar in the two groups (p > 0.05).

Conclusions: Immediate postoperative catheter removal does not appear to be an unsafe practice compared with continuous postoperative urinary catheterization following bladder perforation as a result of sling trocar placement.

中尿道吊带术膀胱穿孔的术后处理。
引言和假设:对于中尿道吊带放置后膀胱穿孔的处理尚无明确的共识。传统的留置导尿管的使用是令人沮丧的。本研究评估了持续膀胱引流和不持续膀胱引流患者瘘管率的差异。方法:回顾性分析2017年至2023年在某学术中心接受尿道中吊带手术的女性。所有术中膀胱镜检查发现的膀胱穿孔病例均纳入本队列。从电子病历中提取患者信息,包括人口统计学、临床数据和围手术期因素,包括手术类型和术后导管使用。进行描述性统计。结果:在总共1702名接受中尿道悬吊手术的女性中,有97名膀胱镜检查证实有膀胱穿孔。其中96例为耻骨后吊带,1例为经闭吊带。67例患者同时进行盆腔器官脱垂修复,而30例患者未进行任何伴随手术。在该队列中,61例患者在手术当天出院,未使用导尿管,而36例患者术后使用留置导尿管持续膀胱引流。在我们的研究队列中,没有患者发生瘘管。两组患者术后不良反应,包括复发性尿路感染、补片暴露和尿潴留,差异无统计学意义(p < 0.05)。结论:与放置吊带套管针导致膀胱穿孔后持续导尿相比,术后立即拔除导尿似乎并不是一种不安全的做法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.80
自引率
22.20%
发文量
406
审稿时长
3-6 weeks
期刊介绍: The International Urogynecology Journal is the official journal of the International Urogynecological Association (IUGA).The International Urogynecology Journal has evolved in response to a perceived need amongst the clinicians, scientists, and researchers active in the field of urogynecology and pelvic floor disorders. Gynecologists, urologists, physiotherapists, nurses and basic scientists require regular means of communication within this field of pelvic floor dysfunction to express new ideas and research, and to review clinical practice in the diagnosis and treatment of women with disorders of the pelvic floor. This Journal has adopted the peer review process for all original contributions and will maintain high standards with regard to the research published therein. The clinical approach to urogynecology and pelvic floor disorders will be emphasized with each issue containing clinically relevant material that will be immediately applicable for clinical medicine. This publication covers all aspects of the field in an interdisciplinary fashion
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