Postoperative urinary retention by void trial methodology following radical hysterectomy for cervical cancer

• Published in: Gynecologic oncology Vol. 190; pp. 90 - 95
• Main Authors: Wagar, Matthew K., Patel, Ushma J., Bharucha, Kharmen, Heisler, Christine A., Peterson, Megan F., Godecker, Amy, Wallace, Sumer K., Spencer, Ryan J.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2024
• Subjects: Cervical cancer; Radical hysterectomy; Urinary retention; Void trial; Urinary retention; Radical hysterectomy; Cervical cancer; Void trial
• ISSN: 0090-8258; 1095-6859; 1095-6859
• DOI: 10.1016/j.ygyno.2024.08.005

Radical hysterectomy is the standard of care for management of early-stage cervical cancer and is associated with postoperative urinary retention. No clear consensus exists regarding optimal voiding trial methodology for mitigating postoperative urinary retention. Our objective was to evaluate the association between type of postoperative voiding trial and risk of urinary retention after radical hysterectomy for cervical cancer. We conducted a retrospective analysis of patients undergoing radical hysterectomy for apparent early-stage cervical cancer (FIGO 2018 Stage IA2-IB2) between January 2014 and February 2023. We compared incidence of urinary retention and perioperative outcomes based on method of postoperative voiding trial (timed, autofill, or backfill). Multivariate logistic regression was used to determine association of type of void trial with absence of urinary retention within 30 days postoperatively. Of the 115 patients identified, 48 (41.8%) patients completed a timed void trial, 40 (34.7%) an autofill void trial, and 27 (23.5%) a backfill void trial. 44.3% of patients developed postoperative urinary retention with no differences based on void trial (p = 0.17). Urinary retention was more likely to resolve by 7 (p = 0.012) and 30 days (p = 0.01) for patients undergoing backfill voiding trials, compared to other trials. In multivariate models, backfill void trial was associated with absence of 30-day urinary retention, compared to other trials (aOR 15.1; 95% C.I. 1.5–154.9). Rates of urinary retention following radical hysterectomy do not differ based on postoperative void trial methodology. A backfill void trial following radical hysterectomy may lead to increased rates of resolution of postoperative urinary retention. •Incidence of postoperative urinary retention is high in patients undergoing radical hysterectomy for cervix cancer.•Urinary retention is more likely to resolve postoperatively in patients completing a backfill void trial.•Urinary retention rates do not appear to differ by type of postoperative void trial methodology.•A backfill void trial may lead to increased resolution of postoperative urinary retention after radical hysterectomy.