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Incidence of and risk factors for postoperative urinary retention in fast-track hip and knee arthroplasty

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@article{62289985eddb4d729f6506d45fa00abe,
title = "Incidence of and risk factors for postoperative urinary retention in fast-track hip and knee arthroplasty",
abstract = "Background and purpose - Postoperative urinary retention (POUR) is a clinical challenge, but there is no scientific evidence for treatment principles. We describe the incidence of and predictive factors for POUR in fast-track total hip (THA) and knee arthroplasty (TKA). Patients and methods - This was a prospective observational study involving 1,062 elective fast-track THAs or TKAs, which were performed in 4 orthopedics departments between April and November 2013. Primary outcome was the incidence of POUR, defined by postoperative catheterization. Age, sex, anesthetic technique, type of arthroplasty, and preoperative international prostate symptom score (IPSS) were compared between catheterized and non-catheterized patients. Results - The incidence of POUR was 40{\%} (range between departments: 30-55{\%}). Median bladder volume evacuated by catheterization was 0.6 (0.1-1.9) L. Spinal anesthesia increased the risk of POUR (OR = 1.5, 95{\%} CI: 1.02-2.3; p = 0.04) whereas age, sex, and type of arthroplasty did not. Median IPSS was 6 in non-catheterized males and 8 in catheterized males (p = 0.02), but it was 6 in the females in both groups (p = 0.4). Interpretation - The incidence of POUR in fast-track THA and TKA was 40{\%}, with spinal anesthesia and increased IPSS in males as predictive factors. The large variation in perioperative bladder management and in bladder volumes evacuated by catheterization calls for randomized studies to define evidence-based principles for treatment of POUR in the future.",
author = "Bjerregaard, {Lars S} and Stina Bog{\o} and Sofie Raaschou and Charlotte Troldborg and Ulla Hornum and Poulsen, {Alicia Martin} and Per Bagi and Henrik Kehlet",
year = "2015",
doi = "10.3109/17453674.2014.972262",
language = "English",
volume = "86",
pages = "183--188",
journal = "Acta Orthopaedica (Print Edition)",
issn = "1745-3674",
publisher = "Taylor & Francis Ltd",
number = "2",

}

RIS

TY - JOUR

T1 - Incidence of and risk factors for postoperative urinary retention in fast-track hip and knee arthroplasty

AU - Bjerregaard, Lars S

AU - Bogø, Stina

AU - Raaschou, Sofie

AU - Troldborg, Charlotte

AU - Hornum, Ulla

AU - Poulsen, Alicia Martin

AU - Bagi, Per

AU - Kehlet, Henrik

PY - 2015

Y1 - 2015

N2 - Background and purpose - Postoperative urinary retention (POUR) is a clinical challenge, but there is no scientific evidence for treatment principles. We describe the incidence of and predictive factors for POUR in fast-track total hip (THA) and knee arthroplasty (TKA). Patients and methods - This was a prospective observational study involving 1,062 elective fast-track THAs or TKAs, which were performed in 4 orthopedics departments between April and November 2013. Primary outcome was the incidence of POUR, defined by postoperative catheterization. Age, sex, anesthetic technique, type of arthroplasty, and preoperative international prostate symptom score (IPSS) were compared between catheterized and non-catheterized patients. Results - The incidence of POUR was 40% (range between departments: 30-55%). Median bladder volume evacuated by catheterization was 0.6 (0.1-1.9) L. Spinal anesthesia increased the risk of POUR (OR = 1.5, 95% CI: 1.02-2.3; p = 0.04) whereas age, sex, and type of arthroplasty did not. Median IPSS was 6 in non-catheterized males and 8 in catheterized males (p = 0.02), but it was 6 in the females in both groups (p = 0.4). Interpretation - The incidence of POUR in fast-track THA and TKA was 40%, with spinal anesthesia and increased IPSS in males as predictive factors. The large variation in perioperative bladder management and in bladder volumes evacuated by catheterization calls for randomized studies to define evidence-based principles for treatment of POUR in the future.

AB - Background and purpose - Postoperative urinary retention (POUR) is a clinical challenge, but there is no scientific evidence for treatment principles. We describe the incidence of and predictive factors for POUR in fast-track total hip (THA) and knee arthroplasty (TKA). Patients and methods - This was a prospective observational study involving 1,062 elective fast-track THAs or TKAs, which were performed in 4 orthopedics departments between April and November 2013. Primary outcome was the incidence of POUR, defined by postoperative catheterization. Age, sex, anesthetic technique, type of arthroplasty, and preoperative international prostate symptom score (IPSS) were compared between catheterized and non-catheterized patients. Results - The incidence of POUR was 40% (range between departments: 30-55%). Median bladder volume evacuated by catheterization was 0.6 (0.1-1.9) L. Spinal anesthesia increased the risk of POUR (OR = 1.5, 95% CI: 1.02-2.3; p = 0.04) whereas age, sex, and type of arthroplasty did not. Median IPSS was 6 in non-catheterized males and 8 in catheterized males (p = 0.02), but it was 6 in the females in both groups (p = 0.4). Interpretation - The incidence of POUR in fast-track THA and TKA was 40%, with spinal anesthesia and increased IPSS in males as predictive factors. The large variation in perioperative bladder management and in bladder volumes evacuated by catheterization calls for randomized studies to define evidence-based principles for treatment of POUR in the future.

U2 - 10.3109/17453674.2014.972262

DO - 10.3109/17453674.2014.972262

M3 - Journal article

VL - 86

SP - 183

EP - 188

JO - Acta Orthopaedica (Print Edition)

JF - Acta Orthopaedica (Print Edition)

SN - 1745-3674

IS - 2

ER -

ID: 44607185