Urinary Retention Complications Research Articles

The use of Opioids in Total Knee Arthroplasty Patient: Main Characteristics, Risk Factors and Adverse Events

Opioids are frequently used for the treatment of preoperative and postoperative pain among patients undergoing total knee arthroplasty (TKA). The greatest risk for prolonged opioid use after TKA is preoperative opioid use. Despite the effectiveness of multimodal postoperative pain protocols, younger patients with preoperative history of narcotic use require additional opioids and are at a higher risk for complications and a greater length of stay. At 90 days, respiratory complications were the most common opioid-related adverse events (TKA: 6%; RTKA: 8%), followed by postoperative nausea and vomiting (TKA: 3%; RTKA: 4%), and urinary retention complications (TKA: 3%; RTKA: 3%). For TKA, risk factors for respiratory complications included older age, lower socioeconomic status, more comorbidities, obesity, chronic obstructive pulmonary disease, white race, and patients in the Midwest and West (vs. South). The average Medicare payment for treating complications within 90 days of a TKA was $6206 and $6222 following RTKA. Avoidance or weaning of preoperative opioids should be considered.

Post-obstructive diuresis: a complication of urinary retention.

Post-obstructive diuresis: a complication of urinary retention.

Urinary Retention in Adults Male Patients: Causes and Complications among Patients Managed in a Teaching Hospital in North Western Nigeria

Background: Urinary retention is one of the common urologic emergencies constituting a significant workload of urologists and non-urologists alike. Aims and Objectives: This study was undertaken to identify the causes and complications associated with urinary retention in adult male patients at AKTH, Kano. Patients and Methods: It was a prospective hospital-based study of 110 consecutive adult male patients who presented to Aminu Kano Teaching Hospital, Kano with urinary retention over 12 months. On presentation, a brief history was taken and rapid physical examination done; the urinary retention was relieved by urethral catheterization or suprapubic cystostomy. A detailed history and thorough physical examination findings were later obtained. Results: One hundred and ten patients were seen during the study period. There ages ranged from 17 to100 years with a mean of 56 ± 19.3 SD years. Patients within the age range 55 - 74 years accounted for the largest group, (25.5% + 23.6% = 49.1%). The most common cause of urinary retention in this study was benign prostatic hyperplasia (51.8% of the patients). This was followed by urethral stricture (20%), cancer of the prostate (7.3%), urethral injury (7.3%) and bladder tumour (6.4%). More than half of the patients (53.4%) presented with acute urinary retention, 30.5% presented with chronic urinary retention, and 16.1% were diagnosed to have acute-on-chronic urinary retention. The complications of urinary retention found were: urinary tract infection (in 24.5% of patients), renal impairment (14.5%), and anaemia (11.8%). Conclusion: Urinary retention is commoner among the middle aged and the elderly. Benign prostatic hyperplasia remains the leading cause of urinary retention. Acute urinary retention was the commonest type of urinary retention; however, complications due to the retention were associated with chronic and acute-on-chronic urinary retention.

Measurement of Post-void Residual Bladder Volumes in Hospitalized Older Adults

BackgroundIt is commonly recommended to catheterize or closely follow up patients with post-void residual volumes of 150 mL or more, but the frequency of such findings in geriatric hospitalized patients and the need for intervention are unclear. MethodsPost-void residual volumes were measured by ultrasound examination within 14 hours of admission in 464 patients aged 70 years or more who were hospitalized in a regional hospital general internal medicine department. Outcome variables included the need for an indwelling catheter and complications of urinary retention during the hospitalization. ResultsPost-void residual volumes of ≥150 mL were common (23.9%; 111/464) and had the following distribution: 150 to 299 mL, 13.1% (61/464); 300 to 499 mL, 6.4% (30/464); and 500 mL or more, 6% (28/464). The rate of indwelling catheters was 3.2% (15/464). Results of post-void residual volumes did not predict the need for indwelling catheters in those without other criteria, although those with indications for indwelling catheters had a significantly higher frequency of post-void residual volumes ≥500 mL (P < .001) compared with those without such indications. ConclusionsWe conclude that urinary retention in hospitalized geriatric patients is common, but measurements of post-void residual volumes did not have definite clinical utility. However, the study had limited power to determine the benefits or potential harms of urinary catheterization for elevated post-void residual volumes.

A review of the effects of spinal anaesthetic in lower limb orthopaedic surgery on urinary retention

Summary This review explores the literature relating to the complication of urinary retention following spinal anaesthesia and in particular, in relation to lower limb orthopaedic surgery. It critically reviews aspects of care management and analyses the implications for clinical practice, as it is important to understand if interventions are causing more problems for patients and if there is a better way of reducing the risks of urinary retention, bladder distension and catheterisation.

Extended sector biopsy for detection of carcinoma of the prostate

Purpose: To determine whether an extended sector biopsy of the prostate will increase the detection of prostate cancer, without causing an increase in morbidity. Materials and Methods: A total of 74 men with a mean age of 62.3 years (46–98 years) who either had an elevated PSA or an abnormal digital rectal exam underwent a transrectal ultrasound guided needle biopsy. Beginning on 7/1/98, an extended sector biopsy technique was performed on 74 patients by one urologist (RRB). Each transrectal ultrasound guided needle biopsy included 12 total cores (normal sextant biopsy, 2 in each peripheral zone, and 2 in the transition zone). We retrospectively reviewed the biopsy results for the location of cancer. PSA data and morbidity of the procedures were reviewed. Results: Of 74 total patients, 40 (54.1%) were positive for adenocarcinoma of the prostate. There were 10 positive results detected only in the additional zones. If one looks at the total number of cancers detected (40), then 10/40 (25%) of the cancers detected were found in the additional regions only or in 13.5% of all patients biopsied. Of the 10 patients with sector only prostate cancer, 8 were detected in the peripheral zone, 1 in the transition zone and 1 in both zones. All 10 patients had a Gleason pattern score 3+3=6 or 4+3=7. There were no atypical or PIN cores found in the sector zones only. PSA ranged from 1.2–142 (median 6.0 ng/ml). The median PSA was 6.2 ng/ml in all patients found to have cancer, and 6.0 ng/ml in the cancers detected only in the additional zones. There was 1 (1.4%) complication of urinary retention and fever. Conclusion: Our study suggests that an extensive sector biopsy may increase the detection of prostate cancer by 13.5% over a routine sextant biopsy, without demonstrable serious morbidity.