Bladder Dysfunction after Gynecologic Laparoscopic Surgery for Benign Disease

Abstract

Study Objective To estimate the incidence of and factors leading to bladder dysfunction after laparoscopic gynecological surgery for benign disorders. Design Prospective observational study (Canadian Task Force Classification II-3). Setting Tertiary referral hospital in Sydney, Australia. Patients One hundred eight women undergoing elective laparoscopic surgery for benign gynecological disease. Intervention Prospective assessment bladder function. Data were collected with respect to preoperative baseline bladder function, demographic, intraoperative and postoperative data and bladder function and time to discharge. Measurements and Main Results Postoperative bladder dysfunction was defined as a residual of >100 mL after a void of >150 mL on more than 1 occasion or a bladder volume >600 mL with no urge to void, with 20/102 (19.6%) women having postoperative bladder dysfunction. There was no statistically significant difference in baseline bladder function, mean operative time, anatomic site of surgery, number of operative sites, type of disease, duration of catheterization, or units of morphine required during hospitalization for women with or without bladder dysfunction. Women with dysfunction had a statistically significant greater length of stay from removal of catheter to discharge (28 vs 44 hours; p =.04). Conclusion Postoperative bladder dysfunction appears idiosyncratic, with no single factor predictive of this problem. Possibilities for the demonstrated rate of dysfunction include normal bladder behavior, unmasking future bladder dysfunction, response to drugs, or neurologic issues. The implications of postoperative bladder dysfunction may have consequences for health care resource use and allocation, acute patient management, and possible long-term urinary function consequences and are worthy of further study.