Impact of Retained Cystoscopy Fluid after Laparoscopic Hysterectomy: A Randomized Controlled Trial

J Minim Invasive Gynecol. 2021 Feb;28(2):288-296. doi: 10.1016/j.jmig.2020.05.024. Epub 2020 Jun 4.


Study objective: To investigate the impact of retained cystoscopy fluid after laparoscopic hysterectomy on time to spontaneous void, time to discharge, urinary retention, bladder discomfort, and patient satisfaction.

Design: Single-blind randomized controlled trial.

Setting: An academic medical center.

Patients: One hundred and twenty patients who underwent laparoscopic hysterectomy with universal cystoscopy for benign indications, excluding pelvic organ prolapse and urinary incontinence indications.

Interventions: From October 10, 2018, to October 17, 2019, we compared 200 mL retained cystoscopy fluid and complete bladder emptying after laparoscopic hysterectomy with universal cystoscopy.

Measurements and main results: A total of 120 patients were enrolled and randomized (59 in the retained cystoscopy fluid group and 61 in the emptied fluid group). The primary outcome was time to first spontaneous void. The secondary outcomes were time to discharge, urinary retention rates, bladder discomfort, and patient satisfaction. A sample size of 120 was calculated to detect a 57-minute difference in time to spontaneous void. There were minimal differences in baseline demographics and surgical characteristics between the groups. There was an apparent, although not significant, difference in time to void of 25 minutes (143 minutes vs 168 minutes, p = .20). Time to discharge and urinary retention rates did not differ (199 minutes vs 214 minutes, p = .40, and 13.6% vs 8.2%, p = .51, respectively). There was no difference in postoperative bladder discomfort and patient satisfaction.

Conclusion: Retained cystoscopy fluid after laparoscopic hysterectomy did not significantly affect time to first spontaneous void, time to discharge, urinary retention, bladder discomfort, or patient satisfaction.

Trial registration: NCT03646136.

Keywords: Bladder backfill; Retained fluid; Universal cystoscopy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cystoscopy / adverse effects*
  • Cystoscopy / methods
  • Female
  • Humans
  • Hysterectomy / adverse effects*
  • Hysterectomy / methods
  • Laparoscopy / adverse effects
  • Laparoscopy / methods
  • Middle Aged
  • Patient Discharge / statistics & numerical data
  • Pelvic Organ Prolapse / epidemiology
  • Pelvic Organ Prolapse / etiology
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Period
  • Single-Blind Method
  • Urinary Bladder / injuries
  • Urinary Bladder / pathology
  • Urinary Bladder / surgery
  • Urinary Incontinence / epidemiology
  • Urinary Incontinence / etiology
  • Urinary Retention / epidemiology
  • Urinary Retention / etiology*

Associated data