The association between regional anesthesia and acute postoperative urinary retention in women undergoing outpatient midurethral sling procedures

• Published in: American journal of obstetrics and gynecology Vol. 200; no. 5; pp. 571.e1 - 571.e5
• Main Authors: Wohlrab, Kyle J., MD, Erekson, Elisabeth A., MD, Korbly, Nicole B., MD, Drimbarean, Calin D., MD, Rardin, Charles R., MD, Sung, Vivian W., MD, MPH
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Mosby, Inc 01.05.2009; Elsevier
• Subjects: Acute Disease; Adult; Aged; Anesthesia; Anesthesia, Conduction - adverse effects; Anesthesia, Epidural - adverse effects; Anesthesia, General - adverse effects; Anesthesia, Spinal - adverse effects; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Cohort Studies; Female; General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation; Gynecology. Andrology. Obstetrics; Humans; Logistic Models; Medical sciences; Middle Aged; midurethral sling; Multivariate Analysis; Nephrology. Urinary tract diseases; Obstetrics and Gynecology; Postoperative Complications - chemically induced; Postoperative Complications - epidemiology; Retrospective Studies; Risk Factors; spinal anesthesia; Suburethral Slings; urinary retention; Urinary Retention - chemically induced; Urinary Retention - epidemiology; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland; Urination; Urologic Surgical Procedures; midurethral sling; spinal anesthesia; urinary retention; Human; Postoperative; Voiding dysfunction; Urinary system disease; Regional anesthesia; Acute; Gynecology; Female; Ambulatory; Urinary retention; Woman; Obstetrics
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2008.11.021

Objective The objective of the study was to estimate the association between regional anesthesia and acute postoperative urinary retention in women undergoing outpatient midurethral sling procedures. Study Design We performed a retrospective cohort study of women undergoing outpatient midurethral sling procedures. Exposure was defined as the type of anesthesia, categorized as regional (spinal or combined spinal/epidural) or nonregional (general endotracheal, monitored anesthesia care with sedation, or local). The outcome, acute postoperative urinary retention, was defined as a failed voiding trial prior to discharge. Results A total of 131 women met our inclusion criteria. Forty-two women (32%) had regional anesthesia and 89 (68%) women had non-regional anesthesia. Overall, 48 women (36.6%) had acute postoperative urinary retention. Women who had regional anesthesia had an increased odds (adjusted odds ratio, 4.4; 95% confidence interval, 1.9-10.2) of acute postoperative urinary retention compared with women receiving nonregional anesthesia. Conclusion Regional anesthesia is a risk factor for acute postoperative urinary retention following outpatient midurethral slings.