icodextrin and Urinary-Retention

4% icodextrin is a fluid that can be instilled laparoscopically to prevent adhesion formation. There are few complications reported in the literature associated with its use.. A 38-year-old woman, gravida 2, para 0, abortus 2 underwent laparoscopic salpingectomy. 4% icodextrin was instilled in an effort to prevent adhesion formation. Postoperatively, the patient experienced urinary retention and gross vulvar edema that required foley catheter use until the 4% icodextrin solution had absorbed.. Postoperative complications that may be associated with the use of 4% icodextrin include urinary retention and vulvar edema.

Topics: Adult; Edema; Female; Glucans; Glucose; Humans; Icodextrin; Instillation, Drug; Laparoscopy; Pelvis; Postoperative Complications; Salpingectomy; Salpingitis; Urinary Retention; Vulvar Diseases

Urinary retention is a recognised complication of laparoscopic surgery. Previous work showed an association with 4% icodextrin solution and urinary retention.. To determine the incidence of urinary retention following laparoscopic gynaecological surgery with or without the use of 4% icodextrin.. A prospective observational study of 147 women undergoing laparoscopic gynaecological surgery for benign pathology. Women had their planned laparoscopic procedure and either received icodextrin solution or nothing as determined by their treating surgeon at the time of the operation.. From May 2011 to February 2012, 147 women were approached to participate in the study; of whom, 124 women were included: 62 received icodextrin and 62 did not. The women in the non-icodextrin group were significantly older (P = 0.007) and had a higher BMI (P = 0.03) than those in the icodextrin group. Following surgery, 27/124 (21.8%) women had post-operative urinary retention. Icodextrin was associated with significantly more urinary retention (P = 0.017), but did not extend hospital admission significantly (P = 0.14). The administration of icodextrin was associated with resection of moderate- or severe-stage endometriosis involving multiple surgical sites, whereas women in the non-icodextrin group were more likely to be having a hysterectomy.. In this non-randomised study, there were significantly more women with post-operative urinary retention when icodextrin was used; however, this did not contribute to an extended hospital admission. While there may be confounding factors, women receiving icodextrin should be warned of the possibility of urinary retention post-operatively, but that this is unlikely to affect their stay in hospital.

Topics: Adult; Body Mass Index; Female; Glucans; Glucose; Gynecologic Surgical Procedures; Humans; Icodextrin; Laparoscopy; Postoperative Complications; Tissue Adhesions; Urinary Retention