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Bladder contraction strength parameters poorly predict the necessity of long-term catheterization after a pubovaginal rectus fascial sling procedure
Authors:Groen Jan  Bosch J L H Ruud
Affiliation:Department of Urology, Erasmus Medical Center, PO Box 1738, 3000 DR Rotterdam, The Netherlands. j.groen.1@erasmusmc.nl
Abstract:PURPOSE: We verified if the necessity of long-term catheterization after a pubovaginal rectus fascial sling procedure can be predicted by preoperatively determined bladder contraction strength. MATERIALS AND METHODS: We analyzed the files of 58 consecutive nonneurogenic women who underwent a sling procedure for severe or refractory stress urinary incontinence. Preoperative urodynamic measurements in these patients were re-analyzed using the power factor WF and the bladder contractility index as bladder contraction strength parameters. Catheterization was considered necessary if the patient self-catheterized at least once daily. RESULTS: One patient was lost to followup. Three and 6 months after surgery 24 (42%) of 57 and 18 (33%) of 54 patients were on catheterization. On average patients who were not on catheterization had a stronger bladder but the results were not consistently statistically significant. CONCLUSIONS: A trend toward higher bladder contraction strength in patients not on catheterization was found. However, preoperative urodynamic examination can only poorly predict the necessity of long-term catheterization after sling surgery.
Keywords:bladder   muscle contraction   urinary incontinence   postoperative complications   urinary catheterization
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