8772 The Impact of Acute Urinary Retention Volume on Postoperative Urinary Dysfunction Following Robotic Sacrocolpopexy

Abstract

<h3>Study Objective</h3> Sacrocolpopexy (SCP) for pelvic organ prolapse is typically performed with a midurethral sling (MUS) to treat or prevent postoperative stress urinary incontinence (SUI). A known complication is the development of postoperative urinary dysfunction, namely obstructed voiding, chronic urinary retention (CUR) and eventual sling release. This study aims to investigate whether the degree of acute urinary retention (AUR) is predictive of longer-term sequelae. <h3>Design</h3> Retrospective case control study. <h3>Setting</h3> Academic-affiliated community hospital. <h3>Patients or Participants</h3> All patients (n=708) undergoing a robotic SCP with transobturator MUS placement by a single urogynecologist between January 2012 and March 2022 stratified by their post-void residual bladder volumes (PVRBV) were included in this study. <h3>Interventions</h3> Patients were grouped by their degree of PVRBV: ≤150mL (n=397), >150 and ≤300mL (n=111), >300 and ≤450mL (n=84), and >450mL (n=116). <h3>Measurements and Main Results</h3> Higher volumes of AUR had a statistically significant increase in the percentage chance risk of CUR. (6.3%, 16.2%, 10.7%, 14.7%, p<0.05). A non-statistically significant distribution was observed between PVRBV and requirement for eventual sling release (3%, 1.8%, 0%, 6%, p=0.08). There were no differences in other long term postoperative sequelae amongst variable degrees of acute PVRBV including urinary symptoms, need for postoperative medications or return to the emergency department or hospital readmissions. Patients with greater PVR volumes had lower body mass index (28.7, 27.7, 27.2, 26.8 kg/m², p<0.05). Other demographic variables were similar amongst groups. <h3>Conclusion</h3> Increasing BMI has a protective effect from developing CUR. Higher PVRBV in excess of 150mL were associated with a greater propensity for CUR. This had a trend toward requiring sling release and/or revision. Future studies are necessary to determine whether the degree of AUR is related to the procedure or pre-existing bladder dysfunction.