Incidence and risk factors of postoperative urinary retention in hemiarthroplasty implemented under spinal anesthesia

Abstract

Objective To evaluate the odds and risk factors of postoperative urinary retention (POUR) after hemiarthroplasty by spinal anesthesia. Methods Consecutive patient informations (164 patients and 168 hips) that performed a primary hemiarthroplasty with spinal anesthesia(epidural anesthesia or subarachnoid anesthesia)were recollective investigated from February 2015 to April 2018 in Hainan General Hospital. Inclusion criteria: age older than 18 years and ability of clear conversation. Exclusion criteria: the patients who refused to participation, and the patients in whom preoperative intermittent catheterization was applied till the present, dialysis patients, patients with a history of uriological surgery, and patients with bone tumor.All the patients were voided autonomously and without any indwelling catheter.All the patients were recorded body mass index (BMI), gender, American Society of Anesthesiologists (ASA) grade, and operative duration, postoperative oral acesodyne apply, history of incontinence or polyuria andpostoperatively for urinary retention including urine colour, volume, abdomen symptoms and signs, bladder ultrasound scan was also performed to identify the residual urinary capacity. Categorical variables were analyzed with chi-square testing and continuous variables were analyzed with the Student t test. Results One hundred and sixty one patients were collected into the study eventually. Five patients were excluded for demanding indwelling catheterization in the operative survey. Thirty-eight patients suffered POUR and required immediate catheterization. Seventeen patients finally demanded detaining catheterization for 3-5 d. Five patients who refused to catheterized developed to urinary tract infection and three patients who catheterized were underwent urinary tract infection. POUR was significantly associated with a history of urinary retention and intraoperative fluid volume (t =8.935, P 0.05). Conclusion Patients who have a history of prior urinary retention and those who receive high volumes of intraoperative fluid are at higher risk for POUR following hemiarthroplasty conducted under spinal anesthesia. Key words: Hemiarthroplasty; Urinary retention; Anesthesia, spinal; Complications