Effects of delayed postoperative void and preoperative urologic symptoms on delay in time of discharge for elective lumbar decompression surgery

Brant, Jason E; Smith, Spencer; Radoslovich, Stephanie S.; Wyland, Alden; Walker, Jorge R.; Lieberman, Elizabeth G.; Yoo, Jung U.

doi:10.1016/j.spinee.2021.12.012

Cited by 1 publication

(4 citation statements)

References 35 publications

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“…Reported risk factors were age, sex, BMI, preoperative urologic symptoms, diabetes, volume of infused uid, duration of surgery, and extent of surgery. 18,[22][23][24]33,36,37 Preoperative urologic symptoms were present in 22% of patients in this study and were associated with 24-hour POUR. Brant et al showed that nearly half of the patients had preoperative urinary symptoms and that the urinary symptoms should be inquired about in the preoperative patient evaluations.…”

Section: Discussionmentioning

confidence: 67%

“…Brant et al showed that nearly half of the patients had preoperative urinary symptoms and that the urinary symptoms should be inquired about in the preoperative patient evaluations. 23 There were other important risk factors that this study did not identify. Age was frequently mentioned as a signi cant risk factor for POUR in previous studies.…”

Section: Discussionmentioning

confidence: 74%

“…Brant et al showed that a delayed postoperative void after 4 hours was associated with prolongation of the hospital stay by more than 24 hours. 23 Patients who developed POUR had longer hospital stays than patients who did not develop POUR (3.94 days versus 2.34 days; p = 0.005). 33 This nding is an important consideration when a day surgery or outpatient surgery is being planned for single-level OLIF.…”

Section: Discussionmentioning

confidence: 93%

“…9,12-14,16−20 Postoperative urinary retention (POUR) is a common complication after lumbar spinal surgery and has been reported in 25% of patients. [21][22][23][24] However, POUR after OLIF has not been previously studied, despite the proximity of the superior hypogastric plexus and sympathetic chain in the surgical trajectory. This lack of attention may be explained by the relatively short hospital length of stay (1-2 days for this type of minimally invasive spine surgery 25,26 ), which may result in patients being discharged from the hospital with undetected POUR.…”

Section: Introductionmentioning

confidence: 99%

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Postoperative Urinary Retention After Oblique Lumbar Interbody Fusion Under the Systematic Management Protocol

Lim

Khan

Lee

et al. 2023

Preprint

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Oblique lumbar interbody fusion (OLIF) is a minimally invasive lateral lumbar fusion technique and patients are discharged 1–2 days after surgery. Because OLIF utilizes a retroperitoneal approach close to the superior hypogastric plexus, postoperative urinary retention (POUR) may not be an uncommon problem. The purpose of this study was to present the incidence and outcomes of POUR with a systematic care protocol. The records of 102 consecutive patients (M:F = 34:68; mean age, 68.0 ± 8.4 years) were retrospectively reviewed. After OLIF, the indwelling urinary catheter was immediately removed, and every patient was encouraged to void within 6 hours. The POUR care protocol, following a clinical pathway, was based on residual urine (RU), which was monitored with an ultrasound bladder scan after each voiding or every 6 hours for 48 hours. The incidence rate of POUR was 44% (45/102) at 24 hours, 17% (17/102) at 48 hours, and 2% (2/102) at 1 month. Preoperative urological symptoms (odds ratio [OR], 3.6) and violation of the protocol (OR, 28.0) were risk factors at 24 hours. At 48 hours, violation of the protocol was the only risk factor (OR, 10.5). Identifying risk factors and a preemptive care protocol may reduce permanent POUR.

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