Tamsulosin for Prevention of Urinary Retention After Midurethral Sling.

IMPORTANCE

Midurethral sling (MUS) is a common procedure to correct stress urinary incontinence but carries a risk of postoperative urinary retention (POUR).

OBJECTIVE

The objective of this study was to evaluate the efficacy of perioperative tamsulosin for reducing the incidence of POUR in patients undergoing MUS placement, with or without concomitant pelvic organ prolapse (POP) surgery.

STUDY

DESIGN

This was a retrospective cohort study of female patients who underwent MUS placement, with or without concomitant gynecologic surgery. Patients were excluded if they underwent transobturator or autologous sling placement or had an intraoperative injury requiring prolonged catheterization. Patients who received perioperative tamsulosin were compared with those who did not. Multivariable logistic regression was performed to assess factors associated with POUR. The primary outcome was the incidence of POUR.

RESULTS

A total of 423 patients who underwent MUS placement were eligible for analysis. Of these, 131 (31.0%) patients received perioperative tamsulosin and 292 (69.0%) did not. In the unadjusted analysis, the incidence of POUR was significantly higher in the no-tamsulosin group (18.8% vs 10.6%, P =0.04). However, the multivariable logistic model demonstrated that perioperative tamsulosin was not significantly associated with decreased POUR (OR, 0.61; 95% CI, [0.29-1.28], P =0.19). Patients with a higher body mass index had a reduced likelihood of POUR (OR, 0.94; 95% CI, [0.89-0.99], P =0.02), while patients who underwent a concomitant POP surgical procedure trended toward increased likelihood of POUR (OR, 2.15; 95% CI, [0.97-4.73], P =0.06).

CONCLUSIONS

These findings suggest that patient and procedural characteristics may play a more significant role in POUR risk than perioperative tamsulosin use for patients undergoing MUS placement.