Bladder backfilling versus standard catheter removal for trial of void after outpatient laparoscopic gynecologic surgery: a systematic review and meta-analysis.

Abstract Objective To compare the rate of postoperative urinary retention (POUR) and time to discharge between bladder backfilling and standard catheter removal for void trial (TOV) after outpatient laparoscopic gynecologic surgery. Our secondary objectives were to compare the time to void, postoperative complications and patient satisfaction. Data Sources We searched the PubMed, Ovid Medline, EMBASE, Cochrane Library databases, and relevant reference lists of eligible articles up to March 2021. Methods of Study Selection This review included randomized controlled trials (RCTs) of TOV after outpatient laparoscopic gynecologic surgery. Odds ratios (ORs) with 95% confidence intervals (CIs) and weighted mean differences (WMDs) with 95% CIs were reported. The quality of the studies was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions. Data were analyzed with RevMan 5.4 software. Tabulation, Integration, and Results Five RCTs (n=488) were included. The bladder backfilling group had a significantly shorter time to void than the standard TOV group (WMD=-25.19 min, 95% CI −44.60, −5.77, p=.01). Successful TOV was not significantly different between the two (OR 0.92, 95% CI 0.51–1.65, p =.77), without significant heterogeneity (I2 = 24%). There was also no significant difference in the time to discharge between the two TOV techniques (WMD=-25.19 min, 95% CI −44.60, −5.77, p=.01). There was no significant difference in complication rates or patient satisfaction between the two groups. Conclusion The bladder backfilling technique of TOV after outpatient laparoscopic gynecologic surgery may reduce the time to first spontaneous void without affecting patient satisfaction or postoperative complications, but it does not significantly affect the time to discharge or urinary retention.