Predictors of postoperative urinary retention in outpatient minimally invasive hysterectomy
Publication date: Available online 12 June 2019Source: Journal of Minimally Invasive GynecologyAuthor(s): Sadikah Behbehani, Ritchie Delara, Johnny Yi, Katie Kunze, Elena Suarez-Salvador, Megan WassonAbstractStudy ObjectiveIdentify risk factors associated with postoperative urinary retention in patients undergoing outpatient minimally invasive hysterectomy.DesignRetrospective cohort studySettingAcademic medical centerPatients or ParticipantsAll patients undergoing outpatient minimally invasive hysterectomy between January 2013 to July 2018 were considered for inclusion in the study.InterventionsOutpatient laparoscopic, vaginal, or robotically assisted laparoscopic hysterectomy.Measurements and main results441 patients met inclusion criteria. Postoperative urinary retention occurred in 94 patients, and 347 patients successfully passed their voiding trial in the post anesthesia care unit for a pass rate of 79%. Demographic characteristics were similar, except patients who experienced postoperative urinary retention were less likely to be menopausal (23.4% vs. 34.7%, p= 0.038). Those with urinary retention received more perioperative opioids (morphine milligram equivalent of 14.4 mg vs.11.2 mg, p =0.012), had longer operative times (122.9±55.6 vs. 95.7±42.3 minutes, p
Conclusion: No clear association exists between polypropylene MUS placement and subsequent urethral diverticulum formation. Factors that diminish polypropylene mesh biocompatibility include elevated BMI, menopause, recurrent UTIs, prior pelvic surgeries, and preexisting medical conditions. Symptoms associated with urethral diverticula should prompt a complete urologic workup prior to MUS placement. PMID: 32462011 [PubMed - in process]
ConclusionAlthough there are many causes of recurrent urinary tract infections, this study showed that vaginal pH imbalance and labia minora anatomy in the lower third prominence based on the Banwell classification (type 3) were among the most important causes. Thus, we think that the vaginal anatomy should be evaluated in recurrent UTI patients.
Conditions: Urinary Tract Infections; Menopause Intervention: Sponsor: Hadassah Medical Organization Not yet recruiting
Conclusions Three of the most common vaginal Lactobacillus species inhibit E. coli growth, likely through creating a low pH environment. However, L. iners, one of the most common species found after menopause, does not. These findings might be leveraged to more effectively manage UTIs.
This JAMA Insights summarizes prevention and management recommendations for women with recurrent urinary tract infections (UTIs), and proposes individualizing approaches by age and menopausal status, underlying conditions (eg diabetes), risk of pyelonephritis/sepsis, and patient preferences.
Conclusions: Independent of demographic variables, menopausal transition, postmenopause, and four menopausal symptoms (mood swing, depressive mood, palpitations, and urinary tract infection) increase the risk of depressive symptoms. PMID: 31951757 [PubMed - as supplied by publisher]
AbstractPurpose of ReviewThe purpose of this review article is to summarize the recent literature regarding the effect of hormone replacement therapy on pelvic floor disorders and its role as a preventative or treatment option.Recent FindingsThe recent evidence describing the effect of hormone replacement therapy on pelvic floor disorders is mainly limited to cohort studies, systematic reviews, and secondary analysis of randomized controlled trials such as the Women ’s Health Initiative and Nurses’ Health Study. There are few quality randomized controlled trials, especially within the last 5 years on this ...
Publication date: November–December 2019Source: Journal of Minimally Invasive Gynecology, Volume 26, Issue 7, SupplementAuthor(s): S Behbehani, RRM Delara, J Yi, ME Suarez, K Kunze, MN WassonStudy ObjectiveIdentify risk factors associated with postoperative urinary retention in patients undergoing minimally invasive outpatient hysterectomy.DesignRetrospective cohort studySettingAcademic medical centerPatients or ParticipantsAll patients undergoing outpatient minimally invasive hysterectomy between January, 2013 to July, 2018 were considered for inclusion.InterventionsOutpatient laparoscopic, vaginal, or robotically-a...
ConclusionFor young healthy women, the use of oral probiotic did not affect the U/L ratio.