Systematic review of interventions for the prevention and treatment of postoperative urinary retention

Jackson, Joni; Davies, Philippa; Leggett, Nick; Nugawela, Manjula D; Scott, Lauren J; Leach, Verity; Richards, Alison; Blacker, Anthony; Abrams, Paul; Sharma, Jitendar Kumar; Donovan, Jennifer L.; Whiting, Paul J.

doi:10.1002/bjs5.50114

Cited by 46 publications

(35 citation statements)

References 63 publications

(140 reference statements)

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“…However, prolonged urinary drainage is associated with complications such as urinary tract infections, surgical site infections, and postoperative urinary retention (POUR) following spine surgery [203,204]. Patients who develop POUR after spine surgery are at increased risk of sepsis and have increased LOS and cost to the healthcare system [205,206]. Limited urinary catheterization in patients undergoing spine surgery can potentially avoid or minimize adverse events and facilitate patient ambulation [111].…”

Section: Urinary Drainagementioning

confidence: 99%

Consensus statement for perioperative care in lumbar spinal fusion: Enhanced Recovery After Surgery (ERAS®) Society recommendations

et al. 2021

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BACKGROUND: Enhanced Recovery After Surgery (ERAS) evidence-based protocols for perioperative care have led to improvements in outcomes in numerous surgical areas, through multimodal optimization of patient pathway, reduction of complications, improved patient experience and reduction in the length of stay. ERAS represent a relatively new paradigm in spine surgery. PURPOSE: This multidisciplinary consensus review summarizes the literature and proposes recommendations for the perioperative care of patients undergoing lumbar fusion surgery with an ERAS program.FDA device/drug status: not applicable.

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Section: Urinary Drainagementioning

confidence: 99%

Consensus statement for perioperative care in lumbar spinal fusion: Enhanced Recovery After Surgery (ERAS®) Society recommendations

et al. 2021

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“…[11,12] There are numerous steps reported to prevent postsurgical urinary retention, including the use of parasympathomimetic agents, alpha-adrenergic blockers and anxiolytic agents, restriction of perioperative uid intake, avoidance of anal packing, use of sitz baths, local anesthesia, short-acting anesthesia, and outpatient surgery. [13][14][15] Increased uid intake might cause overdistension of the bladder and dysfunction of the detrusor muscle.…”

Section: Discussionmentioning

confidence: 99%

Do We Need Fluid Restriction After Stapled Hemorrhoidopexy? A Pilot, Double-Blinded, Randomized Controlled Trial

Tsai¹,

Jao²,

Chen³

et al. 2021

Preprint

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Background: Conventional hemorrhoidectomy leads to a high urinary retention rate and fluid restriction is commonly recommended to minimize complications. However, the need for postoperative fluid restriction among patients who have undergone stapled hemorrhoidopexy is unclear. We aimed to determine whether fluid restriction after stapled hemorrhoidopexy with/without partial external hemorrhoidectomy could reduce urinary retention and postoperative pain.Patients And Methods: In this prospective, double-blinded, randomized controlled trial, we enrolled patients who had grade III or IV hemorrhoids and underwent stapled hemorrhoidopexy with/without partial external hemorrhoidectomy; 250 mL/12 h of sterile 0.9% saline was administered to the fluid restriction group after the operation, and 1000 mL/12 h was given to the non-fluid-restriction group. We focused on the need for fluid restriction after stapled hemorrhoidopexy.Results: Fifty patients were studied in two groups. The surgical outcomes of the two groups were no different. The median subjective pain scores at 0, 8, 16, 24 h after the operation showed no significant difference between the two groups (p = 0.55 at 0 h; p = 0.38 at 8 h; p = 0.98 at 16 h; and p = 0.66 at 24 h). The mean times to first urination after the operation were 700.04 ± 455.03 min in the non-fluid-restriction group and 737.16 ± 426.32 min in the fluid-restriction group (no significant difference; p = 0.67). No postoperative urinary retention was found in either group of patients.Conclusions: Fluid restriction after stapled hemorrhoidopexy is unnecessary.Trial registration: This study was reviewed and approved by the Tri-Service General Hospital Institutional Review Board for human subjects (No. 2-106-05-063). This study also had trial registration with clinicalTrials.gov (Identifier: NCT04459039).

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“…Postoperative urinary retention (POUR) is defined as an acute inability to void when the bladder is full after surgery, leading to patient's anxiety, discomfort, urinary tract infections, delayed hospital discharge and/or increased readmission rates (114)(115)(116)(117)(118)(119). Most cases of POUR are associated with surgeries performed on the lumbar spine (15, 116, 119-121).…”

Section: Post-operative Urinary Retentionmentioning

confidence: 99%

Intraoperative Fluid Management in Patients Undergoing Spine Surgery: A Narrative Review

et al. 2020

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Fluid management has been widely recognized as an important component of the perioperative care in patients undergoing major procedures including spine surgeries. Patient-and surgery-related factors such as age, length of the surgery, massive intraoperative blood loss, and prone positioning, may impact the intraoperative administration of fluids. In addition, the type of fluid administered may also affect post-operative outcomes. Published literature describing intraoperative fluid management in patients undergoing major spine surgeries is limited and remains controversial. Therefore, we reviewed current literature on intraoperative fluid management and its association with post-operative complications in spine surgery.

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Systematic review of interventions for the prevention and treatment of postoperative urinary retention

Cited by 46 publications

References 63 publications

Consensus statement for perioperative care in lumbar spinal fusion: Enhanced Recovery After Surgery (ERAS®) Society recommendations

Consensus statement for perioperative care in lumbar spinal fusion: Enhanced Recovery After Surgery (ERAS®) Society recommendations

Do We Need Fluid Restriction After Stapled Hemorrhoidopexy? A Pilot, Double-Blinded, Randomized Controlled Trial

Intraoperative Fluid Management in Patients Undergoing Spine Surgery: A Narrative Review

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