Tension-free vaginal tape: Poor intraoperative cough test as a predictor of postoperative urinary retention

Peter Takacs, Carlos Medina

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

The purpose of this study was to determine if the quality of the intraoperative cough test could help to predict which patient would fail the post void residual test (PVR) immediately after a tension-free vaginal tape (TVT) procedure. Patients undergoing a TVT procedure only, under spinal or local anesthesia were enrolled. Patients were divided into two groups based on the outcome of the first postoperative PVR, failure group (FG) vs successful group (SG). Before adjusting the tape, patients underwent a standardized cough test. The quality of the cough test was determined to be either good or poor based on whether every cough produced a spurt of urine or not. Variables analyzed between the FG and SG were demographic and urodynamic data. Multivariate logistic regression analysis was used to calculate the adjusted odds ratios. Twenty-six (60.5%) women passed and 17 (39.5%) failed the initial postoperative PVR evaluation. There was a 4.89-fold greater odds of failing the postoperative PVR for women 65 and older compared to younger women (OR 4.89, 95% CI [1.07-26.45]). In addition, there was an 8.63-fold greater odds of failing postoperative PVR for patients with poor quality cough test (OR 8.63, 95% CI [1.54-54.66]). However, multivariate logistic regression analysis revealed that poor quality cough test was the only significant predictor for failing a postoperative PVR (OR 6.83, 95% CI [1.39-33.49], P=0.018). A poor quality intraoperative cough test at the time of TVT procedure is a predictor of immediate postoperative urinary retention.

Original languageEnglish
Pages (from-to)1445-1447
Number of pages3
JournalInternational Urogynecology Journal and Pelvic Floor Dysfunction
Volume18
Issue number12
DOIs
StatePublished - Dec 1 2007

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Suburethral Slings
Urinary Retention
Cough
Logistic Models
Regression Analysis
Spinal Anesthesia
Urodynamics
Local Anesthesia
Odds Ratio
Demography
Urine

Keywords

  • Cough test
  • TVT
  • Urinary retention

ASJC Scopus subject areas

  • Urology
  • Obstetrics and Gynecology

Cite this

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title = "Tension-free vaginal tape: Poor intraoperative cough test as a predictor of postoperative urinary retention",
abstract = "The purpose of this study was to determine if the quality of the intraoperative cough test could help to predict which patient would fail the post void residual test (PVR) immediately after a tension-free vaginal tape (TVT) procedure. Patients undergoing a TVT procedure only, under spinal or local anesthesia were enrolled. Patients were divided into two groups based on the outcome of the first postoperative PVR, failure group (FG) vs successful group (SG). Before adjusting the tape, patients underwent a standardized cough test. The quality of the cough test was determined to be either good or poor based on whether every cough produced a spurt of urine or not. Variables analyzed between the FG and SG were demographic and urodynamic data. Multivariate logistic regression analysis was used to calculate the adjusted odds ratios. Twenty-six (60.5{\%}) women passed and 17 (39.5{\%}) failed the initial postoperative PVR evaluation. There was a 4.89-fold greater odds of failing the postoperative PVR for women 65 and older compared to younger women (OR 4.89, 95{\%} CI [1.07-26.45]). In addition, there was an 8.63-fold greater odds of failing postoperative PVR for patients with poor quality cough test (OR 8.63, 95{\%} CI [1.54-54.66]). However, multivariate logistic regression analysis revealed that poor quality cough test was the only significant predictor for failing a postoperative PVR (OR 6.83, 95{\%} CI [1.39-33.49], P=0.018). A poor quality intraoperative cough test at the time of TVT procedure is a predictor of immediate postoperative urinary retention.",
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