Tommi Yrjälä1, Linda Helenius2, Markku Taittonen2, Hanna Oksanen3, Heli Keskinen4, Terhi Kolari5, Ilkka Helenius6. 1. Department of Anaesthesia and Intensive Care, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland. tommi.yrjala@tyks.fi. 2. Department of Anaesthesia and Intensive Care, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland. 3. Department of Paediatric Orthopaedic Surgery, University of Turku and Turku University Hospital, Turku, Finland. 4. Department of Orthopaedics and Traumatology, University of Turku and Turku University Hospital, Turku, Finland. 5. Department of Biostatistics, University of Turku, Turku, Finland. 6. Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Abstract
PURPOSE: To determine predictors for postoperative urinary retention in adolescents undergoing posterior spinal fusion for idiopathic scoliosis. Postoperative urinary retention affects almost every third adolescent after spinal fusion for idiopathic scoliosis. There are limited data regarding the risk factors of postoperative urinary retention in this patient group. METHODS: A retrospective study with prospectively collected urinary retention data from paediatric spine register with 159 consecutive patients (114 females, mean age 15.6 years, range 10-21 years) undergoing pedicle screw instrumentation for adolescent idiopathic scoliosis at a university hospital between May 2010 and April 2020. Postoperative urinary retention was defined as an inability to void after catheter removal and documented residual over 300 mL as confirmed using an ultrasound or by catheterization. RESULTS: Postoperative urinary retention was diagnosed in 33% (53 of 159) of the patients during hospital stay. Opioid amount on the day of catheter removal (OR 6.74 [95% CI: 2.47, 18.36], p < 0.001), male gender (OR 2.26 [95% CI: 1.01, 5.05], p = 0.048), and increasing weight (OR 1.04 [95% CI: 1.01, 1.07], p = 0.014) were associated with postoperative urinary retention. Mean opioid consumption on the day of catheter removal was 0.81 mg/kg (95% CI: 0.66, 0.96) in the retention group vs 0.57 mg/kg (95% CI: 0.51, 0.64) in the non-retention group, p < 0.001. CONCLUSIONS: Higher total opioid consumption, opioid amount on the day of catheter removal, higher weight, and male gender increases the risk of postoperative urinary retention in adolescents with idiopathic scoliosis undergoing posterior spinal fusion.
PURPOSE: To determine predictors for postoperative urinary retention in adolescents undergoing posterior spinal fusion for idiopathic scoliosis. Postoperative urinary retention affects almost every third adolescent after spinal fusion for idiopathic scoliosis. There are limited data regarding the risk factors of postoperative urinary retention in this patient group. METHODS: A retrospective study with prospectively collected urinary retention data from paediatric spine register with 159 consecutive patients (114 females, mean age 15.6 years, range 10-21 years) undergoing pedicle screw instrumentation for adolescent idiopathic scoliosis at a university hospital between May 2010 and April 2020. Postoperative urinary retention was defined as an inability to void after catheter removal and documented residual over 300 mL as confirmed using an ultrasound or by catheterization. RESULTS: Postoperative urinary retention was diagnosed in 33% (53 of 159) of the patients during hospital stay. Opioid amount on the day of catheter removal (OR 6.74 [95% CI: 2.47, 18.36], p < 0.001), male gender (OR 2.26 [95% CI: 1.01, 5.05], p = 0.048), and increasing weight (OR 1.04 [95% CI: 1.01, 1.07], p = 0.014) were associated with postoperative urinary retention. Mean opioid consumption on the day of catheter removal was 0.81 mg/kg (95% CI: 0.66, 0.96) in the retention group vs 0.57 mg/kg (95% CI: 0.51, 0.64) in the non-retention group, p < 0.001. CONCLUSIONS: Higher total opioid consumption, opioid amount on the day of catheter removal, higher weight, and male gender increases the risk of postoperative urinary retention in adolescents with idiopathic scoliosis undergoing posterior spinal fusion.
Authors: David Altschul; Andrew Kobets; Jonathan Nakhla; Ajit Jada; Rani Nasser; Merritt D Kinon; Reza Yassari; John Houten Journal: J Neurosurg Spine Date: 2016-10-21
Authors: Paul F Austin; Stuart B Bauer; Wendy Bower; Janet Chase; Israel Franco; Piet Hoebeke; Søren Rittig; Johan Vande Walle; Alexander von Gontard; Anne Wright; Stephen S Yang; Tryggve Nevéus Journal: Neurourol Urodyn Date: 2015-03-14 Impact factor: 2.696
Authors: J Jackson; P Davies; N Leggett; M D Nugawela; L J Scott; V Leach; A Richards; A Blacker; P Abrams; J Sharma; J Donovan; P Whiting Journal: BJS Open Date: 2018-11-19