Urinary Retention Postoperative Clinical Trial
— OPTIONOfficial title:
Optimization of Spontaneous Trial of Void: a Prospective Cohort Study
Verified date | July 2021 |
Source | Women and Infants Hospital of Rhode Island |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Trial of void (TOV) is a diagnostic test performed on all women who undergo prolapse repair or incontinence surgery, due to the importance of diagnosing postoperative urinary retention (POUR). Incidence of POUR may be as high as 62% in some studies. Timely and accurate diagnosis is important to avoid complications such as urinary tract infection, bladder overdistension, and permanent bladder injury. Despite the frequent use of TOV, there is no gold standard for the test, and it likely has poor specificity, leading to discharge of more patients with catheter than required. This prospective cohort study will seek to establish evidence-based optimal parameters for spontaneous trial of void, a TOV modality that has merit for further evaluation given lower theoretical risk of urinary tract infection.
Status | Active, not recruiting |
Enrollment | 183 |
Est. completion date | December 30, 2021 |
Est. primary completion date | May 10, 2021 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | Female |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - English-speaking women, age >18yo - Scheduled for urogynecology procedure which will need post-operative trial of void (including pelvic organ prolapse and/or stress urinary incontinence repair), with plan for same-day discharge. Exclusion Criteria: - Unable or unwilling to perform self-catheterizatoin either by patient or willing family member - Pre-existing voiding dysfunction defined as documented PVR > 200 mL - Intraoperative urinary tract injury needing indwelling catheter on discharge - Need for overnight admission |
Country | Name | City | State |
---|---|---|---|
United States | Women & Infants Hospital | Providence | Rhode Island |
Lead Sponsor | Collaborator |
---|---|
Women and Infants Hospital of Rhode Island | American Association of Gynecologic Laparoscopists, American Urogynecologic Society |
United States,
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Dieter AA, Amundsen CL, Visco AG, Siddiqui NY. Treatment for urinary tract infection after midurethral sling: a retrospective study comparing patients who receive short-term postoperative catheterization and patients who pass a void trial on the day of surgery. Female Pelvic Med Reconstr Surg. 2012 May-Jun;18(3):175-8. doi: 10.1097/SPV.0b013e3182544e03. — View Citation
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Kleeman S, Goldwasser S, Vassallo B, Karram M. Predicting postoperative voiding efficiency after operation for incontinence and prolapse. Am J Obstet Gynecol. 2002 Jul;187(1):49-52. — View Citation
Kowalik U, Plante MK. Urinary Retention in Surgical Patients. Surg Clin North Am. 2016 Jun;96(3):453-67. doi: 10.1016/j.suc.2016.02.004. Review. — View Citation
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Niël-Weise BS, van den Broek PJ. Urinary catheter policies for short-term bladder drainage in adults. Cochrane Database Syst Rev. 2005 Jul 20;(3):CD004203. Review. Update in: Cochrane Database Syst Rev. 2015;12:CD004203. — View Citation
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Partoll LM. Efficacy of tension-free vaginal tape with other pelvic reconstructive surgery. Am J Obstet Gynecol. 2002 Jun;186(6):1292-5; discussion 1295-8. — View Citation
Pulvino JQ, Duecy EE, Buchsbaum GM, Flynn MK. Comparison of 2 techniques to predict voiding efficiency after inpatient urogynecologic surgery. J Urol. 2010 Oct;184(4):1408-12. doi: 10.1016/j.juro.2010.05.096. Epub 2010 Aug 19. — View Citation
Ripperda CM, Kowalski JT, Chaudhry ZQ, Mahal AS, Lanzer J, Noor N, Good MM, Hynan LS, Jeppson PC, Rahn DD. Predictors of early postoperative voiding dysfunction and other complications following a midurethral sling. Am J Obstet Gynecol. 2016 Nov;215(5):656.e1-656.e6. doi: 10.1016/j.ajog.2016.06.010. Epub 2016 Jun 16. — View Citation
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Wheeler TL 2nd, Richter HE, Greer WJ, Bowling CB, Redden DT, Varner RE. Predictors of success with postoperative voiding trials after a mid urethral sling procedure. J Urol. 2008 Feb;179(2):600-4. Epub 2007 Dec 21. — View Citation
* Note: There are 30 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Incidence of post-operative urinary retention | Based on defined criteria | 24-72 hours postoperative | |
Primary | Diagnostic accuracy of trial of void parameters | Comparison of sensitivity, specificity, positive/negative predictive value of different trial of void parameters from first postoperative void, based on those used in the literature. | First void postoperative (within 4 hours postop) | |
Secondary | Rate of post-operative and post-discharge urinary retention | Based on post-void residual volume | 24-72 hours postoperative | |
Secondary | Rate of post-operative urinary tract infection | UTI in first 6 weeks postoperative | 6 weeks postoperative | |
Secondary | Patient satisfaction with self-catheterization method via questionnaire | Novel questionnaire, 5 point Likert scale from "Very dissatisfied to Very satisfied" | 2 weeks postoperative | |
Secondary | Time to first void postoperative | To assess time to spontaneous void after surgery | 4 hours postoperative |
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