The effect of sugammadex on postoperative urinary retention post-laparoscopic and robotic hysterectomy with and without concomitant procedures

Omar F Dueñas-Garcia; Twisha Shah; Lexi Fritts; Katherine Leung; Nasser Alrayyes; Katerina Garcia; Michael Flynn; Robert Shapiro; Manuel Vallejo

doi:10.1007/s00192-023-05668-1

The effect of sugammadex on postoperative urinary retention post-laparoscopic and robotic hysterectomy with and without concomitant procedures

Int Urogynecol J. 2023 Nov 6. doi: 10.1007/s00192-023-05668-1. Online ahead of print.

Authors

Omar F Dueñas-Garcia¹, Twisha Shah², Lexi Fritts², Katherine Leung³, Nasser Alrayyes², Katerina Garcia², Michael Flynn³, Robert Shapiro⁴, Manuel Vallejo⁵

Affiliations

¹ Obstetrics and Gynecology Department West Virginia University, 1 Medical Centre Drive, Morgantown, WV, 26508, USA. omar.duenasgarcia@hsc.wvu.edu.
² West Virginia University, Medical School, Morgantown, WV, USA.
³ Obstetrics and Gynecology Department, University of Massachusetts, Worcester, MA, USA.
⁴ Obstetrics and Gynecology Department West Virginia University, 1 Medical Centre Drive, Morgantown, WV, 26508, USA.
⁵ Department of Anesthesia and Medical Education, West Virginia University, Morgantown, WV, USA.

PMID: 37930427
DOI: 10.1007/s00192-023-05668-1

Abstract

Introduction and hypothesis: This study was aimed at determining the effect of sugammadex versus a combination of glycopyrrolate and neostigmine (GN) for neuromuscular reversal blockage on transient postoperative urinary retention (TPOUR) in patients undergoing a laparoscopic and robot-assisted laparoscopic hysterectomy.

Methods: We conducted a retrospective cohort study in patients undergoing a laparoscopic or robotic hysterectomy between February 2017 and December 2021. Patients with and without concomitant procedures were included. Demographics and perioperative data were extracted from the patient's medical record. Before discharge, all patients were required to spontaneously void and have a post-void residual of less than 150 ml.

Results: We identified 500 patients and 485 were included in the final analysis. We had 319 subjects who received sugammadex and 166 GN combination. Both groups had overall similar demographics and perioperative characteristics. Most patients had a conventional laparoscopy procedure (391 [82.5%]) compared with robotic (83 [17.5%]). Patients who received GN were significantly more likely to be discharged home with an indwelling catheter (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.09-3.05). After adjusting for perioperative medications and sling implantation during the surgery a logistic regression model continued to demonstrate that patients who received GN had significantly higher odds of being discharged with a catheter (OR, 1.79; 95% CI, 1.03-3.12).

Conclusions: Our findings suggest that sugammadex decreases the odds of TPOUR after laparoscopic hysterectomies with and without slings compared with the combination of GN. Additional prospective trials are required to confirm this finding.

Keywords: Glycopyrrolate; Hysterectomy; Neostigmine; Postoperative urinary retention; Sugammadex.