Risk Factors Of Voiding Dysfunction Research Articles

Risk factors of postoperative voiding dysfunction in children with congenital anorectal malformation

This study analyzed the clinical data of children with anorectal malformation (ARM)who underwent surgery from 2006 to 2021, and explored the related factors of postoperative voiding dysfunction (VD).A total of 60 children including 51 males and 9 females, aged 4-15 years, were enrolled. During follow up, normal voiding function were found in 43 cases, VD in 17 cases. It was found that middle to high clinical classification (OR＝6.732, 95%CI:1.854-24.443), multiple surgeries (OR＝3.712, 95%CI:1.133-12.160), associated spinal deformity (OR＝3.297, 95%CI:1.029-10.566) and abnormal postoperative defecation (OR＝4.971, 95%CI:1.387-17.816) were the risk factors of VD after ARM (all P<0.05). Urodynamic study and early intervention should be carried out in children with VD after ARM surgery.

Risk factors for postoperative voiding dysfunction following surgery for pelvic organ prolapse

ObjectiveShort-term postoperative voiding dysfunction (POVD) is common in women undergoing surgery for pelvic organ prolapse. It results in increased catheter burden for patients and health services, and catheter-associated urinary tract infections (CAUTIs), thereby escalating the overall cost of treatment. Our aim was to determine the risk factors for voiding dysfunction following surgery for POP in our unit. Study designA retrospective case-control study conducted in a tertiary center in the U.K. The study cohort included all women who underwent surgery for pelvic organ prolapse between March 2017 and March 2019 and had a failed trial without catheter (TWOC). The control group comprised consecutive women on the surgical database who passed TWOC. Relevant data, including demographic details, past medical history, intraoperative and postoperative factors, were collected. We used the Chi-square test to calculate the statistical significance and multiple logistic regression analysis using SPSS software to identify the risk factors. Results286 surgeries were performed. After exclusion, 43 patients were included in each group. Baseline demographics were similar in both groups. The incidence of POVD was 15%, and none of our patients had long-term voiding problems. Logistic regression analysis identified five risk factors - advanced pelvic organ prolapse (OR = 2.654, p = 0.029), comorbidities (OR = 4.583, p = 0.019), preoperative anticholinergics and/or antidepressants (OR = 4.440, p = 0.004), sacrospinous hysteropexy/colpopexy (OR = 2.613, p = 0.041) and postoperative opioid use (OR = 3.529, p = 0.004). ConclusionWe identified five risk factors to recognize the women who would benefit from advanced counseling and management plan following surgery for pelvic organ prolapse.

A community-based epidemiological survey of overactive bladder and voiding dysfunction in female Taiwanese residents aged 40 years and above

ObjectiveThis is part of a three-year study designed to evaluate the natural history of lower urinary tract symptoms in local community residents aged 40 years and above in central Taiwan. We evaluated the prevalence of overactive bladder (OAB) and voiding dysfunction (VD) in female residents using validated questionnaires. Materials and MethodsA structured questionnaire containing groups of different questionnaires was translated into Chinese and each one was validated separately. A trained research assistant interviewed the participants and assisted in filling in the questionnaires. Residents were recorded to have OAB if the total OABSS score was≧4. Urge urinary incontinence (UUI) was defined as urine leakage preceded by the feeling of urgency which is slightly or more distressful. VD was defined as feeling of difficulty in emptying the bladder which is slightly or more distressful. ResultsA total of 2411 community residents aged 40 years and above who completed all the questionnaires in the initial survey were recruited, of which 1469(60.9%) were women. The prevalence of OAB, UUI and VD were 33.1%, 26.8% and 28.3% respectively in the female community residents. Age≧60 (OR, 1.5; 95%CI, 1.1–2.0), menopause (OR1.4; 95% CI, 1.0–1.9) and a history of diabetes mellitus (OR, 1.8; 95% CI, 1.2–2.8) were the risk factors for OAB. Age≧60 (OR, 1.4; 95%CI, 1.0–1.9), BMI ≧25 (OR, 1.3; 95% CI, 1.0–1.7) and instrument deliveries (OR, 1.5; 95% CI, 1.0–2.1) were the risk factors for VD. ConclusionOur results imply that the prevalence of overactive bladder and voiding difficulty are high in female community residents aged ≧ 40 years in central Taiwan.

Incidence and risk factors of voiding dysfunction after mid-urethral sling surgery for stress urinary incontinence

Objective To analyze the risk factors of voiding dysfunction after mid-urethral sling surgery for stress urinary incontinence.Methods Clinical data of 573 consecutive patients undergoing midurethral sling surgery from January 2003 to December 2010 were collected and analyzed retrospectively.All relative risk factors were evaluated by univariate and multivariate Logistic analysis to identify risk factors of voiding dysfunction.Results Voiding dysfunction occurred in 28 patients,with an incidence of 4.9％ (28/573).Univariate analysis showed that age,previous pelvic surgery,pre-operative postvoid residuals,maximum flow rate,average urine flow rate,Valsalva leak point pressure,concomitant anterior pelvic repair and operator performing＜50 procedures were the relative risk factors (P＜0.05) for voiding dysfunction.Multivariate logistic regression analysis revealed that the maximum flow rate (Qmax) ≤ 15 ml/s (OR=3.782,P=0.003) was an independent risk factor for voiding dysfunction and surgery experience was its protection factors (OR=0.295,P=0.016).Conclusions Qmax ≤ 15 ml/s on preoperative urodynamic study is an independent risk factor for voiding dysfunction after mid-urethral sling procedure.Improving skill of surgery and strengthening technical training will help to reduce the incidence of this complication. Key words: Urinary incontinence, Stress ; Risk factor; Voiding dysfunction

Oral Presentation 3

OBJECTIVES: The purpose of this study was to determine risk factors for voiding dysfunction necessitating sling revision after midurethral polypropylene sling placement. MATERIALS AND METHODS: This multicenter case-control study included patients who underwent midurethral polypropylene sling placement and subsequent sling revision secondary to voiding dysfunction from January 1999 to January 2007 from nine urogynecologic centers across the US. Controls were patients who had undergone midurethral polypropylene sling placement not necessitating revision and were matched by patient age and date of surgery. Data collected included demographics, urodynamic study data, sling type, operative data, and clinical information before and after sling revision. Univariate analyses identified risk factors for voiding dysfunction, based on chi square tests for categorical variables, independent samples t-tests for normally distributed continuous variables, and Mann-Whitney rank sums tests for non-normally distributed continuous variables. Direct logistic regression analysis was used to determine which diagnostic variables predicted voiding dysfunction necessitating sling revision. RESULTS: One hundred ninety seven patients met case study criteria with 2 controls matched to each case for a total of 394 controls. Two hundred fourteen patients had all data points and were included in the logistic regression analysis. No specific patient characteristics increased the risk for sling revision including: age, race, BMI, smoking status, menopause status, hormone use, COPD/asthma history, previous incontinence or prolapse surgery, prior hysterectomy, preoperative diagnosis, and presence of intrinsic sphincter deficiency. Risk factors for sling revision did include: retropubic sling type (OR = 2.11, 95% CI 1.03–4.34, P = .04) and concurrent surgery (OR = 4.21, 95% CI 1.96–9.04, P = .0002) In contrast, pre-sling post void residual values, maximum detrusor pressures, maximum urinary flow rates, general anesthesia, and sling tensioning with cough/crede versus visual placement did not significantly predict the need for sling revision (all P-values >.05). CONCLUSION: This study determined that the retropubic sling type and concurrent surgery at the time of sling placement are risk factors for postoperative voiding dysfunction and sling revision. Urodynamic findings, baseline demographic information, anesthesia type and sling tensioning technique were not found to be predictive of voiding dysfunction and need for sling revision.

Prevalence and risk factors for bothersome lower urinary tract symptoms in women with diabetes mellitus from hospital-based diabetes clinic

There is limited data on prevalence and risk factors for bothersome lower urinary tract symptoms (LUTS) in women with diabetes mellitus (DM). This study assesses prevalence and risk factors for bothersome LUTS and voiding dysfunction in women with DM. Two hundred twenty women participated in this study. Participants completed the King's health questionnaire and the international consultation on incontinence-female lower urinary tract symptom questionnaire. Symptoms prevalence and urinary flow rate were assessed. Logistic regression models for risk factors of bothersome LUTS and voiding dysfunction were constructed. One hundred forty-eight women completed the study. Sixty-one women (41%) had bothersome LUTS. Urgency incontinence, urgency, and nocturia were the most bothersome. Fifty-six (38%) had voiding dysfunction. Neuropathy and glycosylated haemoglobin were independent risk factors for voiding dysfunction. Voiding dysfunction did not affect quality of life in women with DM. Overactive bladder symptoms are the most bothersome in diabetic women. Neuropathy and glycosylated haemoglobin are risk factors for voiding dysfunction.

Incidence and Risk Factors of Postoperative De Novo Voiding Dysfunction following Midurethral Sling Procedures

Purpose: To compare the incidence of postoperative de novo voiding dysfunction and to identify the risk factors affecting the development of de novo voiding dysfunction after various midurethral sling (MUS) procedures for female stress urinary incontinence (SUI). Materials and Methods: Women with SUI underwent MUS by various procedures [tension-free vaginal tape (TVTR), tension-free vaginal tape obturator (TVTOR), tension-free obturator tape (TOTR), or TVT-secureR]. Cases were reviewed retrospectively with follow-up of at least 6 months. The subjects were divided into 2 groups according to the presence of postoperative de novo voiding dysfunction. De novo voiding dysfunction was defined as a low maximal uroflow rate (Qmax 100 ml) observed at 6 months postoperatively. Clinical and urodynamic parameters were compared between the voiding dysfunction (Group I) and normal voiding (Group II) groups according to MUS procedure. Results: Of the 625 subjects, 163 (26%) patients showed evidence of de novo voiding dysfunction (Group I). Of these 163 subjects, 12 (7.3%) patients complained of voiding symptoms. There was no difference in the incidence of de novo voiding dysfunction according to MUS procedure. Multivariate analysis showed Qmax to be the only independent risk factor for de novo voiding dysfunction. Conclusions: This study confirmed the considerable incidence of postoperative de novo voiding dysfunction, which is, however, mostly asymptomatic. As preoperative Qmax decreased, the chance of postoperative de novo voiding dysfunction increased. Identification of risk factors of voiding dysfunction in women undergoing MUS may help in planning for better follow-up and early detection of possibly inherent late complications of voiding dysfunction. (Korean J Urol 2009;50:762-766) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏