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Preoperative Valsalva voiding increases the risk of urinary retention after midurethral sling placement. Int Urogynecol J 2010 Oct;21(10):1243-6



Pubmed ID




Scopus ID

2-s2.0-77956479782 (requires institutional sign-in at Scopus site)   18 Citations


INTRODUCTION AND HYPOTHESIS: A subset of neurologically normal females void by efficient Valsalva, not detrusor contraction. We determined the incidence of urinary retention following midurethral sling (MUS) placement in women that void by detrusor contraction versus Valsalva.

METHODS: Review of patients undergoing MUS insertion between 2002 and 2009 for urodynamic stress incontinence was performed. Women with concomitant pelvic surgery, previous incontinence surgery, or preoperative incomplete bladder emptying were excluded. Patients were divided into two cohorts based on preoperative urodynamic findings--those that voided with a detrusor contraction >10 cm of water and those that voided by Valsalva.

RESULTS: One hundred seven patients were available for analysis. The postoperative urinary retention rate was 22% and 5% in the Valsalva and non-Valsalva groups, respectively (p < 0.05). Mean retention duration was 3 weeks for each cohort (range 1-6).

CONCLUSIONS: Women voiding by Valsalva are at increased risk of urinary retention following MUS placement.

Author List

Pham KN, Topp N, Guralnick ML, Koduri S, Newcomer JR, O'Connor RC


Michael Guralnick MD Professor in the Urologic Surgery department at Medical College of Wisconsin
Julianne R. Newcomer MD Professor in the Obstetrics and Gynecology department at Medical College of Wisconsin
Robert Corey O'Connor MD Professor in the Urologic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged, 80 and over
Middle Aged
Preoperative Care
Retrospective Studies
Risk Factors
Suburethral Slings
Urinary Retention