MP71-16 RETROSPECTIVE MULTICENTER OBSERVATIONAL STUDY OF IMMEDIATE VOIDING AT END OF CONTINENCE SURGERY [REMOVE

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You have accessJournal of UrologyCME1 Apr 2023MP71-16 RETROSPECTIVE MULTICENTER OBSERVATIONAL STUDY OF IMMEDIATE VOIDING AT END OF CONTINENCE SURGERY [REMOVE] Thomas Kozar, John Michael Kaylor, Cynthia Hinderscheid, Jamee Schoephoerster, Albert Holler, Edward Wright, Joseph Pariser, William Boysen, Lucas Wiegand, Patrick Selph, and Andrew Cohen Thomas KozarThomas Kozar More articles by this author , John Michael KaylorJohn Michael Kaylor More articles by this author , Cynthia HinderscheidCynthia Hinderscheid More articles by this author , Jamee SchoephoersterJamee Schoephoerster More articles by this author , Albert HollerAlbert Holler More articles by this author , Edward WrightEdward Wright More articles by this author , Joseph PariserJoseph Pariser More articles by this author , William BoysenWilliam Boysen More articles by this author , Lucas WiegandLucas Wiegand More articles by this author , Patrick SelphPatrick Selph More articles by this author , and Andrew CohenAndrew Cohen More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003339.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Placement of an artificial urethral sphincter (AUS) for stress urinary incontinence may result in postoperative urinary retention. Therefore, patients often remain catheterized for a 23-hour period, despite a lack of evidence to support this practice. Our study aims to evaluate the feasibility of outpatient, catheter-free continence surgery using a multi-institutional database. We hypothesize that between catheterized controls and patients without a catheter, there would be no difference in rate of urinary retention or post-operative complications. METHODS: We conducted an IRB-approved retrospective review of patients undergoing first-time AUS placement from 2009-2021. Patients were stratified by postoperative catheter status into either immediate decatheterization — leaving the procedure without a catheter — or controls — placement of an indwelling catheter for 23 hours. Data were collected on demographic and surgical variables from five institutions. The primary outcome, urinary retention, was defined as catheterization due to subjective voiding difficulty or documented PVR over 250 mL. Analyses were performed using STATA with p<0.05 considered significant. RESULTS: Our study identified 302 controls and 123 immediate decatheterization. Twenty (6.6%) historic controls and nine (7.3%) immediate decatheterization patients developed urinary retention requiring short term catheterization (p=0.80). The immediate decatheterization cohort had a higher rate of complication (19.2% vs 33.3%), but there was no difference in the rate of urinary tract infections (UTI) (2.6% vs 2.4%, p=0.90), surgical site infections (SSI) (1.3% vs 2.4%, p=0.41), or device erosions between groups (1.7% vs 0.8%, p=0.51). Kaplan-Meier survival analysis revealed no significant difference in the rate of revision surgery (Figure 1). CONCLUSIONS: In our cohort, there was no difference in urinary retention, device erosion, UTI, and SSI rates between immediate intraoperative catheter removal and those catheterized for 23 hours. Early decatheterization enables outpatient incontinence surgery without altering reoperation over medium-term follow up. Source of Funding: None. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1021 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Thomas Kozar More articles by this author John Michael Kaylor More articles by this author Cynthia Hinderscheid More articles by this author Jamee Schoephoerster More articles by this author Albert Holler More articles by this author Edward Wright More articles by this author Joseph Pariser More articles by this author William Boysen More articles by this author Lucas Wiegand More articles by this author Patrick Selph More articles by this author Andrew Cohen More articles by this author Expand All Advertisement PDF downloadLoading ...