• About Us
    • Contact Us
    • Login
    • ObGFirst
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • COVID-19
About Us Contact Us Login ObGFirst
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • COVID-19
Grand Rounds

Meta-Analysis: Does Retrofilling of the Bladder After Gynecological Surgery Decrease Time to Discharge?

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • Many centers require a successful bladder voiding trial prior to patient discharge
  • Thiel et al. (Obstetrics & Gynecology, 2021) compared postoperative bladder retrofilling to passive filling after outpatient gynecologic surgery to evaluate effects on postoperative outcomes including time to hospital discharge

METHODS:

  • Systematic review and meta-analysis
  • Inclusion criteria
    • RCTs
    • Studies that compared postoperative bladder retrofilling to passive filling in patients who underwent outpatient gynecological surgery by any approach
  • Study design
    • Mean differences and relative risk (RR) were calculated for the meta-analysis
    • Risk of bias was assessed using the Cochrane Risk of Bias Tool
  • Primary outcome
    • Time to first void
  • Secondary outcomes
    • Time to discharge
    • Postoperative urinary retention
    • Urinary tract infection
    • Patient satisfaction

RESULTS:

  • 8 studies | 1173 patients
  • Bladder retrofilling in the operating room resulted in a significant decrease in
    • Time to first void
      • Mean difference −33.5 minutes (95% CI, −49.1 to −17.9)
      • 4 studies, 403 patients
    • Time to discharge
      • Mean difference –32.0 minutes (95% CI, −51.5 to −12.6)
      • 9 studies, 1164 patients
  • Bladder retrofilling did not shorten time to discharge when performed In the postanesthetic care unit
    • Mean difference –14.8 min (95% CI, −62.6 to 32.9)
    • 3 studies, 258 patients
  • After laparoscopic hysterectomy
    • Bladder retrofilling did decrease time to first void
      • Mean difference –26.9 min (95% CI, −37.9 to −15.8)
    • No difference in time to discharge
      • Mean difference –26.0 min (95% CI, −56.5 to 4.5)
      • 5 studies, 657 patients
  • There were no differences between the retrofill and passive fill groups for
    • Postoperative urinary retention
      • RR 0.77 (95% CI, 0.45 to 1.30)
      • 5 studies, 910 patients
    • Risk of urinary tract infection
      • RR 0.50 (95% CI, 0.14 to 1.77)
      • 4 studies, 387 patients

CONCLUSION:

  • Retrofilling the bladder in the operating room after outpatient gynecological surgery can reduce the time to first successful void trial and time to discharge, with no evidence of adverse events
  • The authors state

In an era of increasing emphasis on health care resource efficiency, this inexpensive and straightforward intervention should be considered for inclusion in outpatient surgical recovery protocols

Although time to discharge was not reduced, clinicians should not discount postoperative bladder filling for outpatient hysterectomy because it is a safe, simple intervention that facilitates a quicker time to first void

Learn More – Primary Sources:

Retrograde Bladder Filling After Outpatient Gynecologic Surgery: A Systematic Review and Meta-analysis

Want to stay on top of key guidelines and research papers?

ObGFirst® – Try It Free! »

image_pdfFavoriteLoadingFavorite
< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

Does Drinking Coffee Speed Gut Recovery Post GYN Surgery?
Could Chewing Gum Speed Recovery Following Cesarean Section?
Post-Operative Care: Can an e-Health Program Pick up the Slack?
Preoperative Bowel Prep for Gyn Surgery: Does It Actually Improve Surgical Outcomes?

Sections

  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • COVID-19

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site