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

Abstract Objective Short-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 design A 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. Results 286 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). Conclusion We identified five risk factors to recognize the women who would benefit from advanced counseling and management plan following surgery for pelvic organ prolapse.