Feasibility and safety of non-indwelling urinary catheter in patients received primary hip or knee arthroplasty

Abstract

Objective To evaluate the feasibility and safety of non-indwelling urinary catheter in the patients who receive unilateral primary hip or knee arthroplasty. Methods A retrospective study was carried out to analyze 109 patients who received unilateral primary hip or knee arthroplasty during Nov 2015 to Oct 2016 in China-Japan Friendship Hospital with non-indwelling catheter (NIC) and without obvious risk factors for urinary retention, preoperative urinary tract infection, urinary tract irritation or severe hepatorenal insufficiency. According to 1 ∶1 matching pair principle, they were paired with patients who received unilateral primary hip or knee arthroplasty with indwelling catheter (IC) during the same period. The feasibility and safety of non-indwelling urinary catheter was analyzed and evaluated by comparing the incidence of postoperative urinary retention, urinary retention recurrence, catheter-related bladder discomfort, urinary irritation symptoms, urinary tract infection, adverse events, postoperative hospitalization time and patient satisfaction between the NIC and IC groups. The SPSS19.0 statistics software was used to test the measurement data of normal distribution by paired t test, the measurement data of non-normal distribution by Wilcoxon signed rank sum test and the enumeration data by χ2 test. Results There was no significant difference (P>0.05) in terms of postoperative urinary retention, urinary retention recurrence or urinary tract infection between the two groups. The incidence of catheter-related bladder discomfort, urinary irritation symptoms, adverse events and postoperative hospitalization time in NIC group was significantly less and patient satisfaction was significantly higher than IC group (χ2=10.844, P<0.05). The rate of unnecessary catheterization in the patients who receive unilateral primary hip or knee arthroplasty was 81.7%. Conclusion Non-indwelling urinary catheter in patients who received primary hip or knee arthroplasty is safe and reliable, which could reduce the incidence of catheter-related bladder discomfort, urinary irritation symptoms and adverse events effectively, and shorten the postoperative hospitalization time, improve early patient satisfaction. Key words: Urinary catheters; Hip; Knee; Arthroplasty; Urinary retention