Yong-Han Cha1, Young-Kyun Lee2, Seok-Hyung Won2, Jung Wee Park2, Yong-Chan Ha3, Kyung-Hoi Koo2,4. 1. Department of Orthopaedic Surgery, Eulji University Hospital, Daejeon, South Korea. 2. Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea. 3. Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, South Korea. 4. Seoul National University College of Medicine, Seoul, South Korea.
Abstract
PURPOSE: Postoperative urinary retention (POUR) is a common complication after total joint arthroplasties (TJAs). The POUR is managed with urinary catheterization, which is associated with a risk of urinary tract infection and subsequent periprosthetic joint infection. The purpose of this review was to afford a comprehensive understanding of POUR and its management. METHODS: We identified 15 original articles concerning POUR after TJA, which were published from January 2010 to February 2019. The diagnostic method, incidence, risk factors, and management of POUR of the 15 studies were reviewed. RESULTS: The incidence of POUR was ranged from 4.1% to 46.3%. Ultrasound was used for the detection of POUR among the total of the 15 studies. The following factors of old age, male gender, benign prostatic hypertrophy, history of urinary retention, spinal/epidural anesthesia, excessive fluid administration, patient-controlled analgesia, the use of opiates, underlying comorbidities, and poor American Society of Anesthesiologists (ASA) grade were risk factors for POUR. Most of the studies did not use indwelling catheterization during surgery. The POUR patients were managed with intermittent catheterization. The most common volume criterion for bladder catheterization was 400 mL. In inevitable use of an indwelling catheter, it should be removed within 48 h. CONCLUSIONS: This review provided an up-to-date guide for the detection and management of POUR. LEVEL OF EVIDENCE: Level III.
PURPOSE:Postoperative urinary retention (POUR) is a common complication after total joint arthroplasties (TJAs). The POUR is managed with urinary catheterization, which is associated with a risk of urinary tract infection and subsequent periprosthetic joint infection. The purpose of this review was to afford a comprehensive understanding of POUR and its management. METHODS: We identified 15 original articles concerning POUR after TJA, which were published from January 2010 to February 2019. The diagnostic method, incidence, risk factors, and management of POUR of the 15 studies were reviewed. RESULTS: The incidence of POUR was ranged from 4.1% to 46.3%. Ultrasound was used for the detection of POUR among the total of the 15 studies. The following factors of old age, male gender, benign prostatic hypertrophy, history of urinary retention, spinal/epidural anesthesia, excessive fluid administration, patient-controlled analgesia, the use of opiates, underlying comorbidities, and poor American Society of Anesthesiologists (ASA) grade were risk factors for POUR. Most of the studies did not use indwelling catheterization during surgery. The POURpatients were managed with intermittent catheterization. The most common volume criterion for bladder catheterization was 400 mL. In inevitable use of an indwelling catheter, it should be removed within 48 h. CONCLUSIONS: This review provided an up-to-date guide for the detection and management of POUR. LEVEL OF EVIDENCE: Level III.
Entities:
Keywords:
complication; incidence; risk factor; total joint arthroplasty; urinary retention
Authors: Robert James Magaldi; Sara Elaine Strecker; Carl W Nissen; Robert James Carangelo; John Grady-Benson Journal: Arthroplast Today Date: 2022-01-20