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

2018 ◽  
Vol 36 (3) ◽  
pp. 261-265 ◽  
Author(s):  
Shinya Hayami ◽  
Masaki Ueno ◽  
Manabu Kawai ◽  
Toshiyuki Kuriyama ◽  
Tomoyuki Kawamata ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Epidural Catheter ◽  
Urinary Retention ◽  
Epidural Anesthesia ◽  
Urethral Catheter ◽  
Optimal Order ◽  
Postoperative Urinary Retention ◽  
Epidural Opioid ◽  
Epidural Catheters ◽  
Tract Infections

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.

Postoperative urinary retention

1927 ◽  
Vol 23 (2) ◽  
pp. 247-247
Author(s):  
M. Friedland
Keyword(s):  
Abdominal Surgery ◽  
Urinary Retention ◽  
Intravenous Injection ◽  
Postoperative Urinary Retention

Postoperative urinary retention, which occurred in the practice of Vozza, in 124 women after abdominal surgery and delivery, was eliminated by the author in 90% of all cases by intravenous injection of 5 to 10 cc. 40% solution of urotropine.

scholarly journals What Time of Day Should a Urethral Catheter be Removed?

1987 ◽  
Vol 80 (12) ◽  
pp. 755-756 ◽  
Author(s):  
A Wyman
Keyword(s):  
Urinary Retention ◽  
Bladder Neck ◽  
Acute Urinary Retention ◽  
Neck Surgery ◽  
Time Of Day ◽  
Urethral Catheter ◽  
Postoperative Urinary Retention ◽  
Bladder Neck Surgery

Patients who had undergone bladder neck surgery were randomized to having their urethral catheters removed either early in the morning or late at night. There was no difference in the incidence of urinary retention between these two groups of patients. However, patients who presented with acute urinary retention had a higher incidence of postoperative urinary retention. This study suggests that a urethral catheter may be safely removed in the evening without increasing the risk of urinary retention. There also seems to be no greater chance of the patient having to be recatheterized at an unsocial hour.

scholarly journals PENGARUH BLADDER TRAINING TERHADAP PERCEPATAN PENGELUARAN URINE PADA IBU POST SECTIO CAESAREA DENGAN RETENSIO URINE DI RUMAH SAKIT GRANDMED LUBUK PAKAM TAHUN 2020

2020 ◽  
Vol 3 (1) ◽  
pp. 96-104
Author(s):  
Juni Mariati Simarmata ◽  
Syatriawati Suhaimi ◽  
Miftahul Zannah ◽  
Arfah May Syara ◽  
Rosita Ginting ◽  
...  
Keyword(s):  
Urinary Retention ◽  
Muscle Tone ◽  
Foley Catheter ◽  
Bladder Capacity ◽  
Pelvic Surgery ◽  
Sectio Caesarea ◽  
Bladder Training ◽  
Urine Retention ◽  
Postoperative Urinary Retention ◽  
Tract Infections

Urinary retention in women is most likely to occur in the post-caesarean section or after pelvic surgery.  According to Stanton, urinary retention is the inability to urinate for 24 hours which requires catheter assistance, where the inability to pass urine is more than 25-50% of the bladder capacity.  When urinary retention occurs, non-invasive methods are first attempted such as bladder training using Sitz bath hydrotherapy so that the urinary elimination function can occur spontaneously.  If these efforts are unsuccessful, bladder training with catheterization is required by inserting a foley catheter in the bladder for 24 - 48 hours to keep the bladder empty and allow the bladder to regain its normal muscle tone to achieve spontaneous urination. Postoperative urinary retention is the patient's inability to urinate after surgery even though the patient's bladder is full, in most cases, postoperative urine retention does not last long, but in some cases postoperative urinary retention can be prolonged even for days after surgery.  especially if properly identified and handled.  Postoperative urinary retention can cause several complications such as urinary tract infections, bladder overdistention, detrusor damage and can lead to hydronephrosis and kidney damage which can lead to chronic kidney disease, especially in elderly patients.

scholarly journals Suprapubic bladder drainage and epidural catheters following abdominal surgery—A risk for urinary tract infections?

PLoS ONE ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. e0209825
Author(s):  
Johanna Wagner ◽  
Barbara Eiken ◽  
Imme Haubitz ◽  
Sven Lichthardt ◽  
Niels Matthes ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Abdominal Surgery ◽  
Urinary Tract Infections ◽  
Bladder Drainage ◽  
Epidural Catheters ◽  
Tract Infections

Microbial Examination of Kidney Lithotripter Tub Water and Epidural Anesthesia Catheters

1986 ◽  
Vol 7 (4) ◽  
pp. 216-219 ◽  
Author(s):  
Glenn L. Cooper ◽  
James T. Roberts ◽  
Amapola O'Brien ◽  
Marie Kelleher ◽  
Stephen P. Dretler ◽  
...  
Keyword(s):  
Epidural Catheter ◽  
Epidural Anesthesia ◽  
Tap Water ◽  
Microbial Colonization ◽  
Entry Site ◽  
Coagulase Negative Staphylococci ◽  
Occlusive Dressing ◽  
Skin Flora ◽  
Hospital Patients ◽  
Epidural Catheters

AbstractKidney lithotripsy patients frequently receive epidural anesthesia via indwelling epidural catheters. In our hospital, patients are immersed in a tub of warm, continuously-flowing tap water. The epidural catheter-entry site is covered by a transparent occlusive dressing. To determine the risk of microbial colonization of the epidural catheter during lithotripsy, we performed quantitative cultures of tub water and semiquantitative cultures of catheters in 63 lithotripsy procedures. Most of the tub water organisms were typical tap water and skin flora isolates. Total colony counts were generally low with no significant progression during the course of serial procedures. Forty-two epidural catheters were cultured; 34 (81%) were sterile, 8 (19%) were colonized with small numbers of flavobacteria or coagulase-negative staphylococci. Only four catheters had organisms present on catheter segments covered by the transparent occlusive dressing (in each case there was a single colony forming unit per semiquantitative plate) and these organisms were probable contaminants. We conclude that with our current lithotripsy procedures, the risk for the development of epidural catheter-associated infection seems to be low.

Local Anesthetic Test Dose as a Predictor of Effective Epidural Opioid Analgesia

1995 ◽  
Vol 83 (1) ◽  
pp. 96-100. ◽  
Author(s):  
Sandra R. Weitz ◽  
Kenneth Drasner
Keyword(s):  
Epidural Catheter ◽  
Local Anesthetic ◽  
Test Dose ◽  
Sensory Block ◽  
Opioid Analgesia ◽  
Analog Scale ◽  
Sensory Blockade ◽  
Morphine Infusion ◽  
Epidural Opioid ◽  
Epidural Catheters

Background When local anesthetic is used to produce epidural anesthesia intraoperatively, epidural catheter placement is confirmed. However, when epidural catheters are placed intraoperatively only to provide postoperative opioid analgesia, correct catheter placement may not be confirmed by administration of a local anesthetic. The current study tests the hypothesis that the extent of sensory blockade produced by a 10-ml dose of 1.5% lidocaine can be used to predict the adequacy of epidural opioid analgesia. Methods Forty-nine patients undergoing major abdominal surgery in whom a lumbar epidural catheter was placed intraoperatively were studied, but no more than 3 ml 1% lidocaine had been injected. Placement of the epidural catheter was assessed in the postanesthesia care unit by administration of a 10-ml dose of 1.5% lidocaine. The extent of sensory blockade was determined using the pinprick technique: All dermatomes, T2 and below, were assessed and scored using 1 point per dermatome per side from L1 to T2 to a maximum of 24 points. Scores were arbitrarily divided into three groups, where group 1, 0-7 points; group 2, 8-15 points; and group 3, 16-24 points. Epidural morphine infusion was initiated independently of the extent of the sensory blockade and adjusted using predetermined guidelines. Adequacy of opioid-induced analgesia was determined using the visual analog scale. Results Significantly lower visual analog scale scores for pain at rest and with movement from epidural morphine infusion were associated with sensory blockade score of 16-24 points. Seven patients failed to obtain a detectable sensory block. No patient requested alternative analgesia. None of the epidural catheters was removed because of inadequate pain relief, even in patients who failed to obtain a detectable sensory block. Conclusions Extensive sensory block from 10 ml 1.5% lidocaine was associated with excellent epidural opioid analgesia. Extent of analgesia after a 10-ml test dose of 1.5% lidocaine can be used to predict the adequacy of analgesia resulting from an epidural opioid infusion. The failure of a local anesthetic dose to produce sensory blockade does not necessarily predict a failure to produce analgesia from an epidural opioid infusion, as indicated by the presence of analgesia in several patients without detectable sensory block.

scholarly journals Postoperative Urinary Retention Following General Anesthesia for Endoscopic Nasal Surgery in Men Aged Older Than 60 Years: A Retrospective Study

2021 ◽  
pp. 014556132110331
Author(s):  
Yong Won Lee ◽  
Bum Sik Kim ◽  
Jihyun Chung
Keyword(s):  
General Anesthesia ◽  
Incidence Rate ◽  
Urinary Retention ◽  
Nasal Surgery ◽  
Prostate Hyperplasia ◽  
Postoperative Urinary Retention ◽  
Asa Classification ◽  
History Of ◽  
Male Patients ◽  
Endoscopic Nasal Surgery

Objectives: Postoperative urinary retention (POUR) is influenced by many factors, and its reported incidence rate varies widely. This study aimed to investigate the occurrence and risk factors for urinary retention following general anesthesia for endoscopic nasal surgery in male patients aged >60 years. Methods: A retrospective review of medical records between January 2015 and December 2019 identified 253 patients for inclusion in our study. Age, body mass index (BMI), a history of diabetes/hypertension, American Society of Anesthesiologists (ASA) classification, and urologic history were included as patient-related factors. Urologic history was subdivided into 3 groups according to history of benign prostate hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and current medication. The following was analyzed as perioperative variables for POUR development: duration of anesthesia and surgery; amount of fluid administered; rate of fluid administration; intraoperative requirement for fentanyl, ephedrine, and dexamethasone; postoperative pain; and analgesic use. Preoperatively measured prostate size and uroflowmetry parameters of patients on medication for symptoms were compared according to the incidence of urinary retention. Results: Thirty-seven (15.7%) patients developed POUR. Age (71.4 vs 69.6 years), BMI (23.9 vs 24.9 kg/m2), a history of diabetes/hypertension, ASA classification, and perioperative variables were not significantly different between patients with and without POUR. Only urologic history was identified as a factor affecting the occurrence of POUR ( P = .03). The incidence rate among patients without urologic issues was 5.9%, whereas that among patients with BPH/LUTS history was 19.8%. Among patients taking medication for symptoms, the maximal and average velocity of urine flow were significantly lower in patients with POUR. Conclusions: General anesthesia for endoscopic nasal surgery may be a potent trigger for urinary retention in male patients aged >60 years. The patient’s urological history and urinary conditions appear to affect the occurrence of POUR.

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