TY - JOUR
T1 - Diagnostic accuracy of retrograde and spontaneous voiding trials for postoperative voiding dysfunction
T2 - A randomized controlled trial
AU - Geller, Elizabeth J.
AU - Hankins, Kelly J.
AU - Parnell, Brent A.
AU - Robinson, Barbara L.
AU - Dunivan, Gena C.
PY - 2011/9
Y1 - 2011/9
N2 - Objective: To compare the diagnostic accuracy of two voiding trial methods to predict postoperative voiding dysfunction. Methods: Women undergoing operations for urinary incontinence, prolapse, or both urinary incontinence and prolapse from November 2009 and March 2010 were randomized into one of two groups: retrograde or spontaneous. All patients underwent both techniques of voiding trials with randomization determining order. Results: Fifty women were randomized to 25 per group. Failure rates were 62% for retrograde and 84% for spontaneous. Women who failed both had 12.6±14.4 days of retention compared with 2.5±2.1 days for those who failed only one method (P=.004). The retrograde method had 94.4% sensitivity and 58.1% specificity to detect postoperative voiding dysfunction lasting at least 7 days compared with the spontaneous method with 100% sensitivity and 25.8% specificity. Positive and negative predictive values for the retrograde method were 56.7% and 94.7%, respectively, compared with the spontaneous method with 43.9% and 100%. Retrograde was preferred by patients (51.1% compared with 44.4%) regardless of randomization. Conclusion: The retrograde method is more accurate in evaluating postoperative voiding dysfunction, although both tests had a low positive predictive value. A longer period of retention was seen with failure of both methods. Retrograde was preferred by patients and provides an efficient alternative to the spontaneous method of voiding trial.
AB - Objective: To compare the diagnostic accuracy of two voiding trial methods to predict postoperative voiding dysfunction. Methods: Women undergoing operations for urinary incontinence, prolapse, or both urinary incontinence and prolapse from November 2009 and March 2010 were randomized into one of two groups: retrograde or spontaneous. All patients underwent both techniques of voiding trials with randomization determining order. Results: Fifty women were randomized to 25 per group. Failure rates were 62% for retrograde and 84% for spontaneous. Women who failed both had 12.6±14.4 days of retention compared with 2.5±2.1 days for those who failed only one method (P=.004). The retrograde method had 94.4% sensitivity and 58.1% specificity to detect postoperative voiding dysfunction lasting at least 7 days compared with the spontaneous method with 100% sensitivity and 25.8% specificity. Positive and negative predictive values for the retrograde method were 56.7% and 94.7%, respectively, compared with the spontaneous method with 43.9% and 100%. Retrograde was preferred by patients (51.1% compared with 44.4%) regardless of randomization. Conclusion: The retrograde method is more accurate in evaluating postoperative voiding dysfunction, although both tests had a low positive predictive value. A longer period of retention was seen with failure of both methods. Retrograde was preferred by patients and provides an efficient alternative to the spontaneous method of voiding trial.
UR - http://www.scopus.com/inward/record.url?scp=80052167329&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80052167329&partnerID=8YFLogxK
U2 - 10.1097/AOG.0b013e318229e8dd
DO - 10.1097/AOG.0b013e318229e8dd
M3 - Article
C2 - 21860294
AN - SCOPUS:80052167329
SN - 0029-7844
VL - 118
SP - 637
EP - 642
JO - Obstetrics and gynecology
JF - Obstetrics and gynecology
IS - 3
ER -