Post-Operative Urinary Retention Rates after Autofill versus Backfill Void Trial Following Total Laparoscopic Hysterectomy: A Randomized Controlled Trial

ABSTRACT Study Objective To compare the rate of postoperative urinary retention (POUR) after total laparoscopic hysterectomy (TLH) using the autofill versus the backfill void trial. Secondary objectives were to compare the time to discharge from the recovery room, rate of postoperative urinary tract infection (UTI), perceived bladder condition, bladder function impact on life, and patient satisfaction. Design Randomized controlled trial. Setting Single academic medical center. Patients Women who underwent TLH by conventional laparoscopy or robotic-assisted laparoscopy for benign non-urogynecologic indications. Interventions After TLH, participants were randomized to have an autofill void trial (group A) or a backfill void trial once able to ambulate (group B). Failure rate, time to discharge, and UTI rate were assessed. Participants completed the patient perception of bladder condition (PPBC) and the incontinence impact questionnaire-short form (IIQ-7) questionnaires. Patient satisfaction was assessed. Multiple regression analysis was performed to determine predictors of POUR. Measurements and Main Results 82 participants completed the study after randomization: 42 in group A and 40 in group B. There were no statistically significant differences in demographic or perioperative outcomes. Seven participants had POUR in group A (16.7%) and 11 in group B (27.5%) (p = .36). The median time to discharge was 176 minutes for group A [160.5, 255.5] and 218 minutes for group B [180, 265] (p = 0.01). There were no statistically significant differences in rate of postoperative UTI (p = 1.00), PPBC scores (p = 0.24), IIQ-7 scores (p = 0.23), and patient satisfaction scores (p = 0.26). A stepwise logistic regression analysis did not demonstrate any predictors of POUR. Conclusion Backfill void trial once the participant was able to ambulate was not superior to the autofill void trial with respect to the rate of POUR.. The autofill void trial resulted in faster same-day discharge.