Risk factor analysis for postoperative urinary retention after surgery for degenerative lumbar spinal stenosis

Lee, Sungjoon; Kim, Chi Heon; Chung, Chun Kee; Park, Sung Bae; Yang, Seung Heon; Kim, Soo Hyun; Kang, Suk‐Ho; Choi, Yunhee

doi:10.1016/j.spinee.2016.03.017

Cited by 43 publications

(69 citation statements)

References 36 publications

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“…In this study, age and timing of epidural catheter removal were extracted as the causes of POUR. Older age was previously reported as a risk factor for POUR [14][15][16]. Rectal surgery could also be a risk factor [17,18].…”

Section: Discussionmentioning

confidence: 88%

Optimal Timing of Removal of Epidural and Urethral Catheters to Avoid Postoperative Urinary Retention Undergoing Abdominal Surgery

Hayami¹,

Ueno²,

Kawai³

et al. 2018

Dig Surg

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Background/Aims: Postoperative urinary retention (POUR) is one of the most frequent complications of epidural anesthesia. This study aims to clarify risk factors of POUR and to estimate the appropriate timing of urethral catheter removal. Methods: Between September and December 2014, a retrospective cohort study was conducted on 120 patients who underwent epidural anesthesia and major abdominal surgery. To observe trends in incidence of POUR, we analyzed the order and interval of removal of epidural and urethral catheters using Cochran-Armitage trend test. Results: In this study, 40 patients were diagnosed with POUR (33.3%). Median removal of epidural catheters was 4 postoperative days in the POUR group and 3.5 postoperative days in the non-POUR group (p = 0.04). When the urethral catheter was removed before epidural catheter, incidence of POUR was comparatively greater (p < 0.001). There were no statistical differences in surgical fields, operation approach, epidural catheter levels, or epidural opioid use. No patients had urinary tract infections. Conclusion: We demonstrated that removal of urethral catheter before epidural catheter contributed to increasing trends in incidence of POUR. The optimal order and interval of removal of epidural and urethral catheters should be considered to avoid POUR after abdominal surgery.

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Section: Discussionmentioning

confidence: 88%

Optimal Timing of Removal of Epidural and Urethral Catheters to Avoid Postoperative Urinary Retention Undergoing Abdominal Surgery

Hayami¹,

Ueno²,

Kawai³

et al. 2018

Dig Surg

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show abstract

“…Balderi and Carli [16] defined POUR as a bladder volume of more than 600 ml after self-voiding as measured by ultrasound. Lee et al [6] defined POUR as the inability to urinate or a residual urine volume of more than 100 ml after selfvoiding for two days after surgery. It has been reported that a normal bladder volume is 400-600 ml in healthy adults and that individuals begin to feel the sense of voiding at a bladder volume of 150 ml [17].…”

Section: Discussionmentioning

confidence: 99%

“…A previous study described age 50 years or older, more than 750 ml of intraoperative fluid, and bladder volume more than 270 ml on arrival in PACU as predictive factors of POUR [18]. Another study reported that elderly and lengthy operation time were significant risk factors for POUR [6]. The effect of morphine on the lower urinary tract is complex.…”

Section: Discussionmentioning

confidence: 99%

Sugammadex use can decrease the incidence of post-operative urinary retention by avoiding anticholinergics: a retrospective study

et al. 2018

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“…Although several studies have investigated the risk factors of POUR after lumbar spinal surgery, to the best of our knowledge, no study has explored the management of POUR in clinical practice [ 11 , 12 ]. We suggest that a voiding care protocol should be developed for the management of patients after spinal surgery.…”

Section: Introductionmentioning

confidence: 99%

Risk and Management of Postoperative Urinary Retention Following Spinal Surgery

2017

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PurposePostoperative urinary retention (POUR) is a common complication after spinal surgery. However, no clear definition of POUR currently exists, and no studies have evaluated the management of POUR. We aimed to investigate the prognostic factors for eventual POUR-free status in spinal surgery patients. MethodsThe records of patients who received a urologic consultation for POUR from January 2015 to December 2016 were reviewed. POUR-free status was defined as a voiding volume (VV) >100 mL and a VV ratio >50%. Patients with an indwelling Foley catheter and those with any postoperative complications were excluded. The patients were divided into 2 groups according to the primary management method (Foley catheterization [FC] or intermittent catheterization [IC]). ResultsIn total, 205 patients (median age, 70.6 years) were evaluated. Significant prognostic factors for eventual POUR-free status were intraoperative FC, previous spinal surgery, operative level (L3–5), lumbar fusion, and total volume (TV) at the time of POUR. Bladder training and medication did not reduce the time to POUR-free status. In patients who underwent FC, the duration of indwelling FC was a significant prognostic factor for POUR-free status. In a subanalysis, the TV (≥500 mL) and VV ratio at the time of POUR were significant prognostic factors for POUR-free status after primary management. Among the patients who achieved a POUR-free status, 8 (6.4%) experienced recurrent POUR. The VV ratio (<62.0%) was the only predictor of recurrent POUR. ConclusionsThe criterion of POUR-free status is useful after spinal surgery. IC and FC were similar in their efficacy for the management of these patients.

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Risk factor analysis for postoperative urinary retention after surgery for degenerative lumbar spinal stenosis

Cited by 43 publications

References 36 publications

Optimal Timing of Removal of Epidural and Urethral Catheters to Avoid Postoperative Urinary Retention Undergoing Abdominal Surgery

Optimal Timing of Removal of Epidural and Urethral Catheters to Avoid Postoperative Urinary Retention Undergoing Abdominal Surgery

Sugammadex use can decrease the incidence of post-operative urinary retention by avoiding anticholinergics: a retrospective study

Risk and Management of Postoperative Urinary Retention Following Spinal Surgery

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