Postoperative Urinary Retention in Modern Rapid Recovery Total Joint Arthroplasty. Issue 10 (15th May 2022)

• Record Type: Journal Article
• Authors: Bracey, Daniel N.; Barry, Kawsu; Khanuja, Harpal S.; Hegde, Vishal
• Is Part Of: Journal of the American Academy of Orthopaedic Surgeons. Volume 30:Issue 10(2022)
• Page Start: 443
• Page End: 447
• Publication Date: 2022-05-15
• Subjects: Orthopedics -- Periodicals; Orthopedic surgery -- Periodicals; Joint Diseases -- Periodicals; Orthopedics -- Periodicals; Orthopedic surgery; Orthopedics; Periodicals; 616.7005
• DOI: 10.5435/JAAOS-D-21-00963
• Languages: English
• ISSNs: 1067-151X

Abstract

Abstract : Postoperative urinary retention (POUR) is a disruptive complication after modern rapid recovery total joint arthroplasty. This review aims to synthesize the recent literature on POUR in the setting of total joint arthroplasty. The incidence of POUR ranges from 5.5% to 46.3%. The lack of a standardized definition of POUR accounts for some of this variability. Risk factors previously associated with the development of POUR include increasing age, male sex, benign prostatic hyperplasia, use of bupivacaine and intrathecal morphine in spinal anesthesia, glycopyrrolate, and volume of intraoperative intravenous fluid administered. Predictive scoring assessments, such as the International Prostate Symptom Score and a newer predictive nomogram, have not been adequately validated by high-quality studies. The treatment of POUR comprises either intermittent or indwelling urethral catheterization. Higher quality prospective studies are needed to allow for the standardization of all aspects of POUR from its diagnostic criteria to its treatment.