Incidence and Risk Factors for Urinary Retention in Patients Undergoing Outpatient Hysterectomy

Abstract

Objectives:

The goals of this research were to identify the incidence of, and risk factors for, postoperative urinary retention in patients who underwent outpatient hysterectomy, and to evaluate the incidence of urinary retention among those patients, according to variable requirements for urinary function in the immediate postoperative time period.

Materials and Measurements:

This retrospective cohort study was conducted in an academic-affiliated community hospital. The subjects were patients who underwent planned outpatient hysterectomies for benign disease from January 2013 to April 2016 at Lahey Hospital and Medical Center, in Burlington, MA.

Results:

A total of 197 patients who underwent outpatient hysterectomy were identified. The average age of the patients was 45.7 ± 6.8 years, and most patients underwent hysterectomy for leiomyomas. Of these cases, 21 (10.6%) had unplanned hospital admissions. The most-common reasons for admission included nausea (3.1%), pain (1.6%), and dizziness (1.0%). Only 1 patient was admitted for urinary retention (0.5%). Six patients (3.0%) were diagnosed with urinary retention, defined as a bladder scan ≥300cc or a postvoid residual ≥200 cc. All patients with urinary retention were identified either immediately postoperatively or during their admissions. No other patients returned to the clinic or were readmitted to the hospital for urinary retention. Patients identified with urinary retention were more likely to have been admitted overnight for other reasons (83.3%). Of the 197 patients, 8 were required to void prior to same-day discharge, based on provider preference. There was no significant difference in patients' characteristics for patients required to void and those who were not required to do so. No patients in the group required to void were diagnosed with urinary retention. There was no difference between the groups with regard to readmissions or return visits for urinary symptoms.

Conclusions:

The incidence of urinary retention after outpatient minimally invasive surgery is low, and, when present, can be identified in the immediate postoperative timeperiod regardless of whether or not the patient is required to void prior to discharge. Therefore, it is safe to discharge patients after minimally invasive hysterectomy without a requirement to void postoperatively. (J GYNECOL SURG 37:252)