Objective: To determine whether patients receiving perioperative glycopyrrolate during midurethral sling surgery had more acute but temporary postoperative urinary retention.
Design: Retrospective cohort from 2006 to 2011.
Setting:Setting: Northern Virginia community urology practice.
Measurements: To minimize variability in surgical technique and postoperative care, all cases were from a single fellowship-trained urologist (DGK) who performed most of the female incontinence procedures for their group. Inclusion criteria were charts of women, 18 years of age or older who had a primary preoperative diagnosis of stress urinary incontinence (SUI) and who underwent a midurethral sling procedure. Of 151 patients charts, 135 met study eligibility: 57 (42.2%) received glycopyrrolate; 78 (57.8%) did not. The postoperative course of those who did and did not receive glycopyrrolate was compared and formed the basis of group allocation. Data collected included age, body mass index, incontinence type, smoking status, diabetes mellitus, surgery performed, anesthesia type, estimated blood loss, intraoperative fluids, surgery end time to void, and postoperative urinary retention.
Main Results: No differences between the groups in baseline or surgical data. Seven patients (5.2%) had acute temporary postoperative retention, two of whom received glycopyrrolate and 5 did not (3.51% vs 6.41%; RR 0.55, 95% CI 0.11 -2.72, P = 0.70). Excluding those with continued persistent voiding dysfunction beyond 48 hours from surgery, only 3 patients (2.22%) had acute temporary postoperative urinary retention: one received glycopyrrolate and two did not (1.75% vs 2.56%; RR 0.68, 95% CI 0.064 - 7.36; P = 0.99).
Conclusion: Acute temporary postoperative urinary retention is rare after midurethral slings. Glycopyrrolate during anesthesia induction does not appear significantly to increase this rate.
Written by:
Miles S, Massengill J, Gruber D, Speroni KG, Gaynor-Krupnick D. Are you the author?
Department of Obstetrics and Gynecology, Division, Female Pelvic Medicine and Reconstructive Surgery Division, Walter Reed National Military Medical Center, 8901 Wisconsin Ave., Bethesda, MD 20889, USA.
Reference: J Clin Anesth. 2013 Sep 2. pii: S0952-8180(13)00216-X.
doi: 10.1016/j.jclinane.2013.05.007
PubMed Abstract
PMID: 24008194
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