Spinal surgery and urinary retention: A review of the literature

2020 ◽  
pp. 205141582091693
Author(s):  
Jonathan Kopel ◽  
Dr Pranav Sharma
Keyword(s):  
Risk Factors ◽  
Urinary Retention ◽  
Spinal Surgery ◽  
Foley Catheter ◽  
Benign Prostatic Hypertrophy ◽  
Level Of Evidence ◽  
Postoperative Urinary Retention ◽  
Pubmed Database ◽  
Surgical Methods ◽  
Duration Of Surgery

Objective: Postoperative urinary retention is a common complication for patients recovering from general anesthesia or invasive surgery near the spinal column. However, no study has systematically reviewed the incidence of postoperative urinary retention for spinal surgeries performed at the cervical, thoracic, or lumbar spinal regions. In this review, we critically analyze and summarize the known literature on the incidence and risk factors associated with postoperative urinary retention after spinal surgery. Methods: A comprehensive literature review was performed at the end of September 2019 within the PubMed database. Results: The average incidence of postoperative urinary retention from nine of the 10 studies was 17.2% with one paper that did not report on postoperative urinary retention incidence. Furthermore, age, male gender, location and history of spinal surgery, duration of surgery, benign prostatic hypertrophy, and Foley catheter were reported as major risk factors for postoperative urinary retention and spinal surgery. Conclusion: Overall, spinal cord and postoperative urinary retention remains a poorly understood area requiring further investigation into the incidence, risk factors, and surgical methods influence postoperative urinary retention and post-operative outcomes. We believe an overview of such data can help revise guidelines for the management of postoperative urinary retention and raise awareness of its prevalence in elderly patients undergoing spinal surgery. Level of evidence: Not applicable for this multicentre audit.

scholarly journals Postoperative urinary retention in patients undergoing elective spinal surgery

2017 ◽  
Vol 26 (2) ◽  
pp. 229-234 ◽  
Author(s):  
David Altschul ◽  
Andrew Kobets ◽  
Jonathan Nakhla ◽  
Ajit Jada ◽  
Rani Nasser ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Urinary Retention ◽  
Spine Surgery ◽  
Spinal Surgery ◽  
Cauda Equina Syndrome ◽  
Foley Catheter ◽  
Cauda Equina ◽  
Leg Pain ◽  
Postoperative Urinary Retention

OBJECTIVE Postoperative urinary retention (POUR) is a common problem leading to morbidity and an increased hospital stay. There are limited data regarding its baseline incidence in patients undergoing spinal surgery and the risk factors with which it may be associated. The purpose of this study was to evaluate the incidence of POUR in elective spine surgery patients and determine the factors associated with its occurrence. METHODS The authors retrospectively reviewed the records of patients who had undergone elective spine surgery and had been prospectively monitored for POUR during an 18-month period. Collected data included operative positioning, surgery duration, volume of intraoperative fluid, length of hospital stay, and patient characteristics such as age, sex, and medical comorbidities. Dialysis patients or those with complete urinary retention preoperatively were excluded from analysis. RESULTS Of the 397 patients meeting the study inclusion criteria, 35 (8.8%) developed POUR. An increased incidence of POUR was noted in those who underwent posterior lumbar surgery, those with benign prostatic hypertrophy (BPH), those with chronic constipation or prior urinary retention, and those using a patient-controlled analgesia pump postoperatively. An increased incidence of POUR was seen with a longer operative time but not with intraoperative intravenous fluid administration. A significant relationship between the female sex and POUR was noted after controlling for BPH, yet there was no association between POUR and diabetes or intraoperative instrumentation. Postoperative retention significantly prolonged the hospital stay. Three patients developed epidural hematomas necessitating operative reexploration, and while they experienced POUR, they also developed the full constellation of cauda equina syndrome. CONCLUSIONS Awareness of the risk factors for POUR may be useful in perioperative Foley catheter management and in identifying patients who need particular vigilance when they are due to void postprocedure. A greater understanding of POUR may also prevent longer hospital stays in select at-risk patients. Postoperative retention is rarely caused by a postoperative cauda equina syndrome due to epidural hematoma, which is also associated with saddle anesthesia, leg pain, and weakness, yet the delineation of isolated POUR from this urgent complication is necessary for optimal patient care.

scholarly journals Urinary retention after total joint arthroplasty of hip and knee: Systematic review

2020 ◽  
Vol 28 (1) ◽  
pp. 230949902090513 ◽  
Author(s):  
Yong-Han Cha ◽  
Young-Kyun Lee ◽  
Seok-Hyung Won ◽  
Jung Wee Park ◽  
Yong-Chan Ha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Retention ◽  
Joint Infection ◽  
Benign Prostatic Hypertrophy ◽  
Level Of Evidence ◽  
Indwelling Catheter ◽  
Incidence Risk ◽  
History Of ◽  
American Society ◽  
Spinal Epidural

Purpose: Postoperative urinary retention (POUR) is a common complication after total joint arthroplasties (TJAs). The POUR is managed with urinary catheterization, which is associated with a risk of urinary tract infection and subsequent periprosthetic joint infection. The purpose of this review was to afford a comprehensive understanding of POUR and its management. Methods: We identified 15 original articles concerning POUR after TJA, which were published from January 2010 to February 2019. The diagnostic method, incidence, risk factors, and management of POUR of the 15 studies were reviewed. Results: The incidence of POUR was ranged from 4.1% to 46.3%. Ultrasound was used for the detection of POUR among the total of the 15 studies. The following factors of old age, male gender, benign prostatic hypertrophy, history of urinary retention, spinal/epidural anesthesia, excessive fluid administration, patient-controlled analgesia, the use of opiates, underlying comorbidities, and poor American Society of Anesthesiologists (ASA) grade were risk factors for POUR. Most of the studies did not use indwelling catheterization during surgery. The POUR patients were managed with intermittent catheterization. The most common volume criterion for bladder catheterization was 400 mL. In inevitable use of an indwelling catheter, it should be removed within 48 h. Conclusions: This review provided an up-to-date guide for the detection and management of POUR. Level of Evidence: Level III.

Incidence and Risk Factors for Postoperative Urinary Retention Following Lumbar Spine Fusion

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
John J. Bowman ◽  
Charles C. Edwards ◽  
Clayton Dean ◽  
Justin Park ◽  
Charles C. Edwards
Keyword(s):  
Risk Factors ◽  
Lumbar Spine ◽  
Urinary Retention ◽  
Spine Fusion ◽  
Postoperative Urinary Retention ◽  
Lumbar Spine Fusion

scholarly journals Risk Factors for Postoperative Urinary Retention in Surgical Population: A Prospective Cohort Study

2020 ◽  
Vol 7 (2) ◽  
pp. 144-148
Author(s):  
Meltem Çakmak ◽  
Murside Yıldız ◽  
İlker Akarken ◽  
Yücel Karaman ◽  
Özgür Çakmak
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Urinary Retention ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Postoperative Urinary Retention

Incidence of and risk factors for postoperative urinary retention in men after carotid endarterectomy

2020 ◽  
Vol 72 (3) ◽  
pp. 943-950
Author(s):  
Laura T. Boitano ◽  
Madeline DeBono ◽  
Adam Tanious ◽  
James C. Iannuzzi ◽  
W. Darrin Clouse ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Endarterectomy ◽  
Urinary Retention ◽  
Postoperative Urinary Retention

scholarly journals Evidence-Based Management of Gout - A Systematic Search and Review

2020 ◽  
Author(s):  
Md Abu Bakar Siddiq
Keyword(s):  
Risk Factors ◽  
Treatment Options ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Pharmacological Agents ◽  
New Synthesis ◽  
Pubmed Database ◽  
Anti Inflammatory ◽  
Clinical Conditions

Gout is the most common form of inflammatory arthritis. Hyperuricaemia is the pre-requisite for gout and is influenced by variable modifiable and non-modifiable risk factors. Clinical features unique for gout are due to deposition of monosodium urate (MSU) crystal in articular and extra articular tissues. Among various treating agents, anti-inflammatory drugs and urate lowering therapies (ULT) are used widely and successfully, however, non-medicinal means are also effective in the disorder. In their updated guidelines, ACR (2012) and EULAR (2016) recommended both medicinal and non-medicinal approaches that could be used in treating gout, though some of the recommendations are based on lower level of evidence. Moreover, researchers’ continued effort in finding new gout managing agents appear promising, for example, role of Lesinurad in gout management (CLEAR1, CLEAR2). In this new synthesis the author is aimed to provide updated information on gout management based on a systematic review including published work within last ten years between 2008 and 2018 and for this purpose, using ‘clinical trials in gout management’ string, published worked searched in PubMed database from 1st September 2018 to 30 October 2018. Besides the recent ACR and EULAR evidence based management guidelines, the author reviewed another 91 (total 93) articles to make this new draft – 39 articles describe role of pharmacological agents and 54 describe different gout risks, pharmacokinetics/pharmacodynamics of ULT, association between raised sUA level and renal impairment, efficacy of non-pharmacological agents in reducing sUA. According to published work, anti-inflammatory agent is the most appropriate drug group in mitigating inflammatory symptoms of gout, though they often adversely affect over other vital 2 organs with impaired function. Besides ULT, uricase analogues are also found useful in non refractory gout. Since anti-inflammatory agents and ULT contraindicate in some clinical conditions, intra-articular steroid and or adrenocorticotropic hormone (ACTH) are appropriate alternatives instead. However, head-to-head comparison between different NSAIDs, NSAID and prednisolone, NSAID and colchicine are yet to perform. Use of combined anti-inflammatory preparations in gout is also based on lower level of evidence. Regarding effective maximum dose and long-standing impact of ULT on vital organs we are yet to reach a conclusion. Likewise, non-medicinal approaches are widely using in achieving target sUA level, though some of them are based on biased study outcomes and or study with inadequate power, requiring further analysis. Among non-pharmacological approaches, life-style modification, restriction of purine rich diets, avoidance of gout inciting agents are important, but inconclusive. Educating patients’ about diseases, risk factors, available treatment options and side effects from them are also important in terms of achieving sUA level, nevertheless too much counseling sometimes could be worthless.

Considering healthcare value and associated risk factors with postoperative urinary retention after elective laminectomy

2020 ◽  
Vol 20 (5) ◽  
pp. 701-707
Author(s):  
Michael Cremins ◽  
Smitha Vellanky ◽  
Grace McCann ◽  
Michael Mancini ◽  
Laura Sanzari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Retention ◽  
Postoperative Urinary Retention ◽  
Associated Risk Factors
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