Login to Access Video or Poster Abstract: MP40-11
Sources of Funding: None

Introduction

To examine if initial postoperative urinary retention after transurethral Macroplastique® (MPQ) bulking agent injection for female stress urinary incontinence (SUI) is a predictor of success.

Methods

Following IRB approval, a prospective database of non-neurogenic women who underwent MPQ injection for SUI due to intrinsic sphincter deficiency under light anesthesia, and were followed for > 6 months was reviewed. Postoperative retention was defined as inability to void after injection requiring a catheter for 24-48 hours, or difficulty voiding immediately postoperatively (post void residual > 200 ml by bladder scan) as charted in the recovery room electronic medical record. Women on self-catheterization, with a supra-pubic tube, those who had a concomitant procedure, or with follow up < 6 months were excluded. Success was defined as patient reporting sufficient continence for not desiring any additional therapy, ie dry or with rare leakage at last visit. Patients were divided into Group 1: Retention post-operatively and Group 2: no retention postoperatively.

Results

From August 2011 to December 2013, 68 of 92 women met all inclusion criteria. Overall 24/68 (35%) patients had retention after surgery. Similar baseline demographics for Group 1 (N=24) and Group 2 (N=44) are shown in Table 1. Success was 88% for group 1 (21/24) versus 23/44 (52%) in group 2 (p<0.008) at median follow-up of 25 (7-52) months in group 1 and 24 (7-53) months in group 2. Similarly there was significantly higher number of patients who were completely dry in Group 1 (19/24) than in Group 2 (8/24) (p< 0.0001). Patients in Group 2 needed significant higher number of repeat endoscopic injections compared to Group 1 (p<0.002)

Conclusions

Postoperative transient retention was seen in nearly one third of women immediately after MPQ injection. At a median follow-up of 2 years, these women remained dry or were markedly improved, and did not desire additional SUI therapy more so than those who voided well initially.

Funding

None