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Journal of Clinical Diagnosis and Treatment

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Voiding trial methods used after prolapse or incontinence surgery

Author(s): Salma Rahimi, Laurephile Desrosiers, Erika Wasenda, Alejandro D Treszezamsky and Charles J Ascher-Walsh*

OBJECTIVE: There are no standardized techniques for trials of void [TOV] after prolapse or incontinence surgery. Our aim was to describe current methods being used by attendees of the American Urogynecologic Society [AUGS] meeting.

METHOD: Surveys were distributed to AUGS attendees [October 2012] and consisted of 18 questions regarding TOV methods and 8 questions regarding respondent characteristics. Statistical analysis was performed with SAS 9.2, with hypothesis testing at 0.05 level of significance.

RESULT: Response rate was 11% [227 of 2000 surveys returned]. Majority of participants were fellowship-trained physicians working in academic settings. Most perform TOV after prolapse and incontinence surgery. 80% instill 300 mL fluid into the bladder prior to catheter removal. Median time given to void was 30 minutes. To determine post void residual volume [PVR], 35% subtract voided from instilled volume, 19% use ultrasound, 10% perform straight catheterization, and 32% report other methods. Most commonly reported PVR volumes at which catheter is replaced were 100 and 150 mL. After failed TOV, most physicians send patients home with indwelling catheters and 50% repeat TOV in 1-3 days. Fifty-seven percent prescribe prophylactic antibiotics while patients have a catheter. Providers from the South and Northeast were more likely to perform TOV compared to providers from the West and Midwest [p<0.0001].

CONCLUSION: Most respondents perform TOV after prolapse or incontinence surgery and prefer a retrograde fill method using a volume of 300 mL, with PVR 100-150mL considered satisfactory. For failed TOV, most send patients home with indwelling catheter and repeat TOV in 1-3 days.

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