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阴道脱垂手术中保留子宫可起到预防术后尿潴留的作用。

Uterus Preservation in Case of Vaginal Prolapse Surgery Acts as a Protector against Postoperative Urinary Retention.

作者信息

Bekos Christine, Morgenbesser Raffaela, Kölbl Heinz, Husslein Heinrich, Umek Wolfgang, Bodner Klaus, Bodner-Adler Barbara

机构信息

Division of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.

Karl Landsteiner Society for Special Gynaecology and Obstetrics, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.

出版信息

J Clin Med. 2020 Nov 23;9(11):3773. doi: 10.3390/jcm9113773.

Abstract

BACKGROUND

The aim of this study was to identify clinical risk factors for increased post-void residual (PVR) volumes in patients undergoing vaginal prolapse surgery and to find out whether uterus preservation or prolapse hysterectomy influences the incidence of postoperative urinary retention.

METHODS

This retrospective study included women who presented with pelvic organ prolapse (POP) and planned prolapse surgery between January 2017 and July 2019. PVR was assessed postoperatively and increased amounts were defined as incomplete voiding with residual urine volume greater than 150 mL.

RESULTS

Increased PVR at the first postoperative day occurred in 31.8% (56/176). Body mass index (BMI) was significantly lower in patients with increased PVR after pelvic floor surgery compared to patients with normal PVR amounts ( = 0.040). Furthermore, during multiple logistic regression analysis, low BMI ( = 0.009) as well as prolapse hysterectomy ( = 0.032) turned out to be the strongest risk factors associated with increased PVR volume.

CONCLUSION

This is the first study identifying prolapse hysterectomy as an independent risk factor for increased PVR after surgical prolapse repair. Our results might be helpful in counseling patients prior to surgery and underline the option of uterus preservation during prolapse surgery in selected cases.

摘要

背景

本研究的目的是确定接受阴道脱垂手术患者术后残余尿量(PVR)增加的临床风险因素,并了解保留子宫或脱垂子宫切除术是否会影响术后尿潴留的发生率。

方法

这项回顾性研究纳入了2017年1月至2019年7月间出现盆腔器官脱垂(POP)并计划进行脱垂手术的女性。术后评估PVR,尿量增加定义为排尿不完全且残余尿量大于150 mL。

结果

术后第一天PVR增加的发生率为31.8%(56/176)。与PVR正常的患者相比,盆底手术后PVR增加的患者体重指数(BMI)显著更低(P = 0.040)。此外,在多因素逻辑回归分析中,低BMI(P = 0.009)以及脱垂子宫切除术(P = 0.032)被证明是与PVR增加相关的最强风险因素。

结论

这是第一项将脱垂子宫切除术确定为手术修复脱垂后PVR增加的独立风险因素的研究。我们的结果可能有助于在手术前为患者提供咨询,并强调在某些情况下脱垂手术期间保留子宫的选择。

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