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.
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