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Several surgical, patient factors increased urinary retention risk after TJA

Issue: July 2018

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BARCELONA, Spain — Use of bupivacaine as a spinal anesthetic, previous urological history and retention-associated medication significantly increased the chance of postoperative urinary retention after total joint arthroplasty, according to results presented at the EFORT Annual Congress.

To identify predictors of developing urinary retention, Rakan Kabariti, PG Cert, BSc(Hons), MBChB, and colleagues collected surgical and patient factors for 158 patients who underwent total hip and knee arthroplasty. Surgical factors included type of spinal anesthesia used, duration of surgery, American Society of Anesthesiologists (ASA) grade, intraoperative fluid use and time from catheter postoperatively, while patient factors were age, gender, any retention-associated medication, previous urological history and BMI.

“We defined postoperative urinary retention in our study as inability to pass urine voluntarily within the first 24 hours following elective lower limb arthroplasty, particularly in hips and knees, leading to the insertion of urinary catheter,” Kabariti said in his presentation.

Kabariti noted 13.3% of patients developed postoperative urinary retention, with men identified as approximately 90% of these patients.

“Unsurprisingly, we found a previous urological history of 62% significantly associated with increased chance of developing postoperative urinary retention and so was being on retention associated medication, 48%,” Kabariti said.

Results showed 10 patients who underwent total hip arthroplasty and 11 patients who underwent total knee arthroplasty experienced retention. Patients had an average ASA grade of 2. Patients had an average time until catheter of approximately 14 hours, according to Kabariti.

“We looked at type of spinal anesthetic used and, interestingly enough, bupivacaine was associated with 57% of postoperative urinary retention patients,” Kabariti said. – by Casey Tingle

Reference

Kabariti R, et al. Paper 2830. Presented at: EFORT Annual Congress; May 30 – June 1, 2018; Barcelona, Spain.

Disclosure: No disclosure information was available at the time of publication.