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.

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.

Risk factors for postoperative urinary retention following elective spine surgery: A meta-analysis

2021 ◽  
Author(s):  
Yu Chang ◽  
Kuan-Yu Chi ◽  
Ta-Wei Tai ◽  
Yu-Sheng Cheng ◽  
Po-Hsuan Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Retention ◽  
Spine Surgery ◽  
Meta Analysis ◽  
Postoperative Urinary Retention

scholarly journals Hemi-Cauda Equina Syndrome from Herniated Lumbar Disc: a Neurosurgical Emergency?

1996 ◽  
Vol 23 (4) ◽  
pp. 296-299 ◽  
Author(s):  
Ronald H.M.A. Bartels ◽  
Joost de Vries
Keyword(s):  
Urinary Retention ◽  
Cauda Equina Syndrome ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Leg Pain ◽  
Motor Deficit ◽  
Duration Of Symptoms ◽  
Radiographic Findings ◽  
Herniated Lumbar Disc ◽  
Symptoms And Signs

AbstractBackground: We report experience with patients presenting with a specific combination of symptoms: unilateral sciatica, unilateral sensibility loss in the dermatomes SI to S5 (hemi-saddle) and subjective micturation problems secondary to ruptured lumbar disc. Because of its similarities with a cauda equina syndrome, this combination of symptoms was thought to be a unilateral cauda equina syndrome and it was called hemi-cauda equina syndrome. Consequently, it was treated as an emergency. Methods: Ten patients were evaluated. They compromised 2.3% of all patients undergoing lumbar discectomy. Results: Outcome is good with only 10% persisting minor neurologic deficit (sensibility loss in dermatomes S3 to S5). With the exception of urinary retention or incontinence, duration of symptoms and signs does not seem to influence outcome. Comparing signs, symptoms and radiographic findings with those of a cauda equina syndrome which were recently and thoroughly studied, they were found to be more severe in cases of cauda equina syndrome. Especially, the good outcome, (apparently unrelated to the duration of symptoms in cases of hemi-cauda equina syndrome) contrasted with the treatment results of cauda equina syndrome. Conclusions: We defined the hemi-cauda equina syndrome from ruptured disc as a combination of unilateral leg pain, unilateral sensibility loss in dermatomes SI to S5 and sphincter paralysis (proven urinary retention or incontinence). Motor deficit is not necessarily present. Emergency surgery is warranted. Patients presenting with micturation complaints other than urinary retention or incontinence do not suffer from a hemi-cauda equina syndrome.

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 Cauda Equina Syndrome Secondary to Leptomeningeal Carcinomatosis of Gastroesophageal Junction Cancer

2016 ◽  
Vol 8 (1) ◽  
pp. 87-91 ◽  
Author(s):  
Amal Alkhotani ◽  
Nouf Alrishi ◽  
M. Salem Alhalabi ◽  
Tahira Hamid
Keyword(s):  
Cauda Equina Syndrome ◽  
Gastroesophageal Junction ◽  
Cauda Equina ◽  
Leptomeningeal Carcinomatosis ◽  
Leg Pain ◽  
Urine Retention ◽  
Gastroesophageal Junction Cancer ◽  
First Case ◽  
Facial Diplegia ◽  
Leg Weakness

Leptomeningeal carcinomatosis (LMC) is a diffuse or multifocal malignant infiltration of the pia matter and arachnoid membrane. The most commonly reported cancers associated with LMC are breast, lung, and hematological malignancies. Patients with LMC commonly present with multifocal neurological symptoms. We report a case of LMC secondary to gastroesophageal junction cancer present initially with cauda equina syndrome. A 51-year-old male patient with treated adenocarcinoma of the gastroesophageal junction presented with left leg pain, mild weakness, and saddle area numbness. Initial radiological examinations were unremarkable. Subsequently, he had worsening of his leg weakness, fecal incontinence, and urine retention. Two days later, he developed rapidly progressive cranial neuropathies including facial diplegia, sensorineural hearing loss, dysarthria, and dysphagia. MRI with and without contrast showed diffuse enhancement of leptomeninges surrounding the brain, spinal cord, and cauda equina extending to the nerve roots. Cerebrospinal fluid cytology was positive for malignant cells. The patient died within 10 days from the second presentation. In cancer patients with cauda equina syndrome and absence of structural lesion on imaging, LMC should be considered. To our knowledge, this is the first case of LMC secondary to gastroesophageal cancer presenting with cauda equina syndrome.

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