Fecal impaction is associated with postoperative urinary retention after hip fracture surgery

Teng, Maëlys; Zerah, Lorène; Rouet, Audrey; Toméo, Charlotte; Verny, Marc; Cohen-Bittan, Judith; Boddaert, Jacques; Haddad, Rebecca

doi:10.1016/j.rehab.2020.101464

Cited by 6 publications

(3 citation statements)

References 27 publications

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“…However, comparisons with our study are problematic, due to the different study design and case mix. Further, the incidence of a urine volume of ≥500 ml is in the higher range in year 1, while those in years 4 and 5 are in the lower ranges, when compared with other studies [20,22,23]. Still, comparison with other studies is difficult as the definition of UR differ.…”

Section: Discussionmentioning

confidence: 68%

“…Specifically, most patients undergoing hip fracture surgery, have several intrinsic and extrinsic factors that increase the risk of urinary retention (UR) [7,8,14,15]. The reported incidence of pre-and post-operative UR varies between 4 and 82% [16][17][18][19][20][21][22][23] and has proven to be a persistent problem in rehabilitation units [24]. Variations in UR rates may explain some of these findings.…”

Section: Introductionmentioning

confidence: 99%

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A co-created nurse-driven catheterisation protocol can reduce bladder distension in acute hip fracture patients - results from a longitudinal observational study

et al. 2022

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Background Urinary retention is common in elderly patients undergoing acute hip fracture surgery. Avoiding overfilling the urinary bladder is important to avoid detrusor muscle damage and associated motility problems. The aim of this study was to analyse associations between the co-creation of a nurse-driven urinary catheterisation protocol and the incidence of bladder distension in patients undergoing hip fracture surgery. Methods This is a single-centre implementation intervention with a retrospective longitudinal observation design, using five measures points, spanning from June 2015 to March 2020. The intervention was theory driven and the participants, together with the facilitators and researcher, co-created a nurse-driven urinary catheterisation protocol. Data were retrieved from the hip fracture register. Uni- and multivariable logistic regressions were used for analyses of changes in bladder distension and urinary volume of ≥500 ml over the years. Results A total of 3078 patients were included over a five-year period. The implementation intervention was associated with a reduction in the proportion of patients with bladder distension of 31.5% (95% confidence interval 26.0–37.0), from year 1 to year 5. The multivariable analysis indicated a 39% yearly reduction in bladder distension, OR 0.61 (95% confidence interval 0.57–0.64, p < 0001). There was a reduction in the proportion of patients with a bladder volume of ≥500 ml of 42.8% (95% confidence interval 36.2–49.4), from year 1 to year 5. The multivariable analysis found a 41% yearly reduction in patients with a bladder volume of ≥500 ml, OR 0.59 (95% confidence interval 0.55–0.64, p < 0.0001). The intervention was associated with improved documentation of both catheter indications and removal plans. Conclusion The use of predefined catheter indications and a tighter bladder scanning schedule were associated with a reduction in the incidence of both bladder distension and urine volume ≥ 500 ml in hip fracture patients. Registered nurses can play an active role in the facilitation of timely and appropriate catheter treatment in patients with hip fractures. Trial registration Clinical Trial Registry ISRCTN 17022695 registered retrospectively on 23 December 2021, in the end of the study, after data collection.

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Section: Discussionmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 99%

A co-created nurse-driven catheterisation protocol can reduce bladder distension in acute hip fracture patients - results from a longitudinal observational study

et al. 2022

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“…112 Fecal impaction has been found to increase the risk of POUR in the orthopedic literature. 113 87.5-Consensus Medications Q37. Is there evidence for the use of drugs in women postoperatively to prevent or treat POUR?…”

Section: Surgical Factors Affecting Pourmentioning

confidence: 99%

Postoperative Urinary Retention

McDermott

Tunitsky-Bitton

Dueñas-García

et al. 2023

UROGC

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This clinical consensus statement on the management of postoperative (<6 weeks) urinary retention (POUR) reflects statements drafted by content experts from the American Urogynecologic Society's POUR writing group. The writing group used a modified Delphi process to evaluate statements developed from a structured literature search and assessed for consensus. After the definition of POUR was established, a total of 37 statements were assessed in the following 6 categories:(1) incidence of POUR, (2) medications, (3) patient factors, (4) surgical factors, (5) urodynamic testing, and (6) voiding trials. Of the 37 original statements, 34 reached consensus and 3 were omitted.

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