N P Kort1, Y Bemelmans1, R Vos2, M G M Schotanus3. 1. Department of Orthopaedic Surgery, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands. 2. Department of Methodology and Statistics, Maastricht University Medical Center, Maastricht, The Netherlands. 3. Department of Orthopaedic Surgery, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands. martijnschotanus@hotmail.com.
Abstract
PURPOSE: Postoperative urinary retention (POUR), defined as the inability to empty the bladder voluntary after surgery, is a commonly reported complication. This study reports the incidence and possible risk factors for POUR after elective fast-track hip or knee arthroplasty when using a nurse-led bladder scan protocol. METHODS: This retrospective cohort study included data from 803 patients who underwent unilateral hip or knee arthroplasty. Patients' digital clinical records were reviewed for eligibility. Patients with incomplete data registration, preoperative bladder volume >250 ml, preexisting bladder catheterization, and/or patients following the outpatient pathway were excluded. Bladder volumes were assessed at different moments pre- and postoperatively. The outcome was the incidence of POUR, defined as the inability to void spontaneously with a bladder volume >600 ml, treated with indwelling catheterization. Further analysis between POUR and non-POUR patients was performed to detect possible risk factors for POUR. RESULTS: Six hundred and thirty-eight patients operated on primary unilateral hip or knee arthroplasty were analyzed. The incidence of POUR was 12.9% (n = 82, 95% CI 9.4-15.5). Gender, age, BMI, ASA classification, preoperative bladder volume, type of anesthesia, type of arthroplasty, and perioperative fluid administration were not significant different between POUR and non-POUR patients. Patients with a bladder volume of >200 ml at the recovery room were at higher risk (OR 5.049, 95% CI 2.815-9.054) for POUR. CONCLUSIONS: When using a nurse-led bladder scan protocol in fast-track hip and knee arthroplasty, the incidence of POUR was 12.9%, with a bladder volume of >200 ml at the recovery room as a risk factor for POUR. LEVEL OF EVIDENCE: A retrospective cohort study, Level III.
PURPOSE:Postoperative urinary retention (POUR), defined as the inability to empty the bladder voluntary after surgery, is a commonly reported complication. This study reports the incidence and possible risk factors for POUR after elective fast-track hip or knee arthroplasty when using a nurse-led bladder scan protocol. METHODS: This retrospective cohort study included data from 803 patients who underwent unilateral hip or knee arthroplasty. Patients' digital clinical records were reviewed for eligibility. Patients with incomplete data registration, preoperative bladder volume >250 ml, preexisting bladder catheterization, and/or patients following the outpatient pathway were excluded. Bladder volumes were assessed at different moments pre- and postoperatively. The outcome was the incidence of POUR, defined as the inability to void spontaneously with a bladder volume >600 ml, treated with indwelling catheterization. Further analysis between POUR and non-POUR patients was performed to detect possible risk factors for POUR. RESULTS: Six hundred and thirty-eight patients operated on primary unilateral hip or knee arthroplasty were analyzed. The incidence of POUR was 12.9% (n = 82, 95% CI 9.4-15.5). Gender, age, BMI, ASA classification, preoperative bladder volume, type of anesthesia, type of arthroplasty, and perioperative fluid administration were not significant different between POUR and non-POUR patients. Patients with a bladder volume of >200 ml at the recovery room were at higher risk (OR 5.049, 95% CI 2.815-9.054) for POUR. CONCLUSIONS: When using a nurse-led bladder scan protocol in fast-track hip and knee arthroplasty, the incidence of POUR was 12.9%, with a bladder volume of >200 ml at the recovery room as a risk factor for POUR. LEVEL OF EVIDENCE: A retrospective cohort study, Level III.
Authors: Vincent Collard; Giovanni Mistraletti; Ali Taqi; Juan Francisco Asenjo; Liane S Feldman; Gerald M Fried; Franco Carli Journal: Anesth Analg Date: 2007-11 Impact factor: 5.108
Authors: Richard Iorio; William Whang; William L Healy; Douglas A Patch; Soheil Najibi; David Appleby Journal: Clin Orthop Relat Res Date: 2005-03 Impact factor: 4.176
Authors: Martijn G M Schotanus; Yoeri F L Bemelmans; P Hugo M van der Kuy; Jacqueline Jansen; Nanne P Kort Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-07-26 Impact factor: 4.342
Authors: Donald E G Griesdale; Jeremy Neufeld; Dale Dhillon; Jennifer Joo; Supna Sandhu; Frank Swinton; Peter T Choi Journal: Can J Anaesth Date: 2011-10-12 Impact factor: 5.063
Authors: Antonio De Vincentis; Astrid Ursula Behr; Giuseppe Bellelli; Marco Bravi; Anna Castaldo; Lucia Galluzzo; Giovanni Iolascon; Stefania Maggi; Emilio Martini; Alberto Momoli; Graziano Onder; Marco Paoletta; Luca Pietrogrande; Mauro Roselli; Mauro Ruggeri; Carmelinda Ruggiero; Fabio Santacaterina; Luigi Tritapepe; Amedeo Zurlo; Raffaele Antonelli Incalzi Journal: Aging Clin Exp Res Date: 2021-07-21 Impact factor: 3.636
Authors: Sruthi Thomas; Nicole Harris; Johanna Dobransky; George Grammatopoulos; Kathleen Gartke; Allan Liew; Steven Papp Journal: Can J Surg Date: 2021-11-25 Impact factor: 2.089