Risk Factors Associated With Development of Urinary Retention Following Posterior Lumbar Spinal Fusion: Special Attention to the Use of Glycopyrrolate in Anesthesia Reversal

Mormol, Jeremy; Basques, Bryce A.; Harada, Garrett K.; Louie, Philip K.; Alter, Kevin; Goldberg, Edward J.; Colman, Matthew W.; An, Howard S.

doi:10.1097/brs.0000000000003678

Cited by 12 publications

(15 citation statements)

References 21 publications

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“…10 POUR is a common postoperative complication of anesthesia and surgery, and has reported incidences of 5% to 70%. 17 Sometimes, POUR continues for 4 to 6 weeks. 18 Numerous factors affect the incidence of POUR, including the age and sex of the patient, the type of surgery performed, the comorbidities present, the drugs administered, the intravenous fluids administered, the duration of surgery, and various anesthesiarelated parameters.…”

Section: Discussionmentioning

confidence: 99%

Effect of glycopyrrolate on the postoperative urine output of patients following kidney transplantation: a retrospective observational study

Koo,

Park,

Jang

et al. 2023

J Int Med Res

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Objectives To compare the urine output and estimated glomerular filtration rate (eGFR) of patients postoperatively administered sugammadex or glycopyrrolate 7 days following kidney transplantation (KT). Methods We retrospectively enrolled 134 consecutive patients who underwent KT under general anesthesia. Their urine output and eGFR were recorded every 24 hours between postoperative day (POD) 1 and 7. We used regression analysis to evaluate the relationship between the reversal agent administered and the outcomes of the participants. Results The urine output and eGFR of the participants did not differ between the two groups. Multivariate analysis showed that body mass index (BMI) (odds ratio (OR) 1.21; 95% confidence interval (CI) 1.05–1.40), diabetes mellitus (OR 3.14; 95% CI 1.07–9.16), neurovascular disease (OR 7.00; 95% CI 1.61–30.42), and the duration of surgery (OR 1.01; 95% CI 1.00–1.01) were associated with lower urine output on POD 7. In addition, only BMI (OR 1.25; 95% CI 1.09–1.42) was associated with low eGFR on POD 7. Conclusions The urine output and eGFR of patients administered sugammadex or glycopyrrolate following KT did not differ 7 days later. Moreover, glycopyrrolate does not affect urine output or eGFR on POD 7, according to multivariate regression analysis.

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Section: Discussionmentioning

confidence: 99%

Effect of glycopyrrolate on the postoperative urine output of patients following kidney transplantation: a retrospective observational study

Koo,

Park,

Jang

et al. 2023

J Int Med Res

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“…Spinal anesthesia does not influence the functions of the bladder sphincter muscle. Common causes of urinary retention include paralysis of the bladder sphincter and insensitivity to the micturition reflex caused by single spinal anesthesia, reflex spasms of the urethral sphincter caused by incision pain after perineum surgery, changes in micturition posture after surgery, excessive fluid replacement, and mental and psychological factors ( 25 , 26 ). Other studies have shown that factors that influence urinary retention after spinal anesthesia include the operation time and local anesthetic dosage ( 27 – 29 ).…”

Section: Discussionmentioning

confidence: 99%

Effect of single spinal anesthesia with two doses ropivacaine on urinary retention after hemorrhoidectomy in male patients

et al. 2023

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BackgroundAnorectal diseases are common in the population and include internal, external, and mixed hemorrhoids. Although hemorrhoid surgery is a brief operation, anesthesia, anesthetic drugs, drug concentrations, and anesthesia level control are closely related to postoperative uroschesis. For hemorrhoid surgery, a single spinal block with ropivacaine is commonly used that blocks the S2-S4 parasympathetic nervous system, which in turn governs the voiding reflex, causing postoperative urinary retention; this affects the recovery of patients. This study was performed to investigate the effects of two doses ropivacaine that provided satisfactory analgesia and muscle relaxation and inhibited adverse reflexes on urinary retention after hemorrhoidectomy.MethodsThe study included 200 male patients who underwent anorectal surgery with American Society of Anesthesiologists (ASA) grade I–II single elective spinal anesthesia between March 2021 and March 2022. Patients were randomly assigned to 2 groups using a random number table: Group A (n = 100) received 10 mg 0.5% ropivacaine (1.5 ml 1% ropivacaine + 1.5 ml 10% glucose = 3 ml), and Group B (n = 100) received 15 mg 0.5% ropivacaine (1.5 ml 1% ropivacaine + 1.5 ml 10% glucose = 3 ml).ResultsThe anal sphincter exhibited good relaxation, and no obvious traction pain or significant difference in the time of muscle strength recovery was observed between the 10 mg and 15 mg 0.5% ropivacaine groups (P > 0.05). The 10 mg 0.5% ropivacaine group had shorter time of micturition exceeding 100 ml and lower voiding International Prostate Symptom Score than the 15 mg 0.5% ropivacaine group (P < 0.01).ConclusionsSingle spinal anesthesia with 10 mg 0.5% ropivacaine not only provides satisfactory anesthetic effect for hemorrhoidectomy but also has less influence on postoperative uroschesis and is worthy of clinical application.Trial registrationThe study was registered in the Chinese Clinical Trial Registry (http://www.chictr.org.cn; identifier: ChiCTR2,100,043,686) on February 27, 2021.

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“…2 We also observed a statistically significant difference in the mean age of patients with and without POUR, with the AE being more prevalent in a relatively older population. 1,5,13,[15][16][17] Although both these observations were initially attributed to the higher prevalence of BPH in both these patient groups (older age and male gender), more recent studies have demonstrated a significant association between POUR and both these parameters, irrespective of the confounding variable. [22][23][24][25] Based on the available evidence, we were unable to clearly identify any cut-off age limit beyond which the need for prophylactic measures against POUR could be advocated.…”

Section: Discussionmentioning

confidence: 99%

“…Included studies are expressed in Table 1. 1,2,5,[12][13][14][15][16][17][18] Data Extraction and Study Quality Assessment Two investigators (LAR, GP) independently extracted data and assessed the quality of the included studies as described below. The data extracted included study design, sample size, demographic details, and any of the aforementioned outcome variables.…”

Section: Study Design and Characteristicsmentioning

confidence: 99%

Risk Factors for Postoperative Urinary Retention Following Lumbar Spine Surgery: A Review of Current Literature and Meta-Analysis

Reed

Mihas

Fortin

et al. 2022

Global Spine Journal

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Study Design Systematic Review and Meta-analysis Objective Postoperative urinary retention (POUR) is a common complication following lumbar spine surgery (LSS) and timely recognition is imperative to avoid long-term consequences. The aim of the current meta-analysis was to systematically review the literature in order to identify risk factors associated with POUR after LSS. Methods In accordance with PRISMA guidelines, a systematic review of the literature was performed using Pubmed, EMBASE, and MEDLINE database for articles on POUR following LSS. A meta-analysis was performed comparing patients with and without POUR; and the factors associated with this adverse event were analyzed. The pooled data were reported as mean differences with 95% confidence intervals (CI; P < .05). Heterogeneity among the studies was evaluated using the I2 statistic. Results The meta-analysis included 10 studies compromised of 30,300 patients. Based on our analysis, patients who were male, were older in age, underwent instrumented fusion, had diabetes mellitus, coronary artery disease, or benign prostatic hypertrophy had significantly higher risk of developing POUR. Additionally, patients in who developed POUR had significantly longer surgical times and higher volumes of intra-operative fluid administration, as compared with non-POUR patients. The POUR patients also had a significantly higher association with urinary tract infection. Prior surgery, BMI, length of stay, and smoking status did not reveal any statistical association with POUR. Conclusions Risk factors associated with POUR following LSS include male gender, older age, longer surgical times, fusion procedures, larger volumes of intraoperative infusions, and associated comorbidities like DM, CAD, and BPH.

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Risk Factors Associated With Development of Urinary Retention Following Posterior Lumbar Spinal Fusion: Special Attention to the Use of Glycopyrrolate in Anesthesia Reversal

Cited by 12 publications

References 21 publications

Effect of glycopyrrolate on the postoperative urine output of patients following kidney transplantation: a retrospective observational study

Effect of glycopyrrolate on the postoperative urine output of patients following kidney transplantation: a retrospective observational study

Effect of single spinal anesthesia with two doses ropivacaine on urinary retention after hemorrhoidectomy in male patients

Risk Factors for Postoperative Urinary Retention Following Lumbar Spine Surgery: A Review of Current Literature and Meta-Analysis

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