VOIDING AFTER BURCH COLPOSUSPENSION AND EFFECTS OF CONCOMITANT PELVIC-SURGERY - CORRELATION WITH PREOPERATIVE VOIDING MECHANISM

Objective: To determine if concomitant abdominal hysterectomy, posteri or colporrhaphy, or preoperative voiding mechanism adversely affect th e duration of voiding dysfunction experienced after Burch colposuspens ion. Methods: A retrospective review was conducted of 154 consecutive women with genuine stress incontinence managed by Burch colposuspensio n over 4 years. Fifty-three (35%) women underwent colposuspension alon e, 33 (22%) underwent colposuspension with posterior colpoperineorrhap hy, and 68 (44%) underwent colposuspension with total abdominal hyster ectomy (TAH). A suprapubic Foley catheter was placed after all operati ons and removed when the post-vein residual urine reached 20% or less of the volume voided on two consecutive attempts. Results: Women who u nderwent colposuspension alone, colposuspension with posterior colpope rineorrhaphy, and colposuspension with TAH required a mean duration of 4.3, 4.3, and 4.8 days of postoperative bladder drainage, respectivel y. These differences were not statistically significant. Women who voi ded with Valsalva maneuver without a detrusor contraction took signifi cantly longer to resume normal micturition than did those who voided w ith a detrusor contraction with or without Valsalva maneuver, or ureth ral relaxation alone (mean 9.0 days compared with 3.6, 4.7, and 4.8 da ys, respectively; P < .001). Conclusion: Concomitant abdominal hystere ctomy or posterior colpoperineorrhaphy did not prolong voiding dysfunc tion after colposuspension. Women who voided with Valsalva maneuver an d without a detrusor contraction took significantly longer to resume n ormal micturition after Burch colposuspension with or without concomit ant TAH.