Incidence Of Postoperative Urinary Retention Research Articles

Epidural Anesthesia for Lumbar Spine Surgery

A retrospective review of the hospital records of 80 patients undergoing elective lumbar spine surgery was performed, in order to determine the effect of anesthetic technique on various clinical parameters. Forty patients receiving epidural bupivacaine anesthesia were matched with 40 patients receiving general endotracheal anesthesia; these two groups were homogeneous based on age, sex, type of operative procedure, and number of spinal levels operated upon. Significant results included lower injectable narcotic requirements (p less than 0.001), lower incidence of postoperative urinary retention (p less than 0.01), and lower operative blood loss (p less than 0.1) for patients receiving epidural anesthesia. Epidural bupivacaine provided satisfactory anesthesia, and allowed intraoperative testing of lower extremity motor function. In a follow-up surgery, 38 of 40 patients who received epidural anesthesia were satisfied with the technique. For patients undergoing decompressive lumbar spine surgery, epidural bupivacaine anesthesia is an effective, well tolerated technique with several potential advantages, and an acceptable incidence of complications, as compared with general endotracheal anesthesia.

Intraoperative endoscopic evaluation of suprapubic urethropexy

In a preliminary study of 32 women with stress urinary incontinence, a modification was added to the standard suprapubic urethropexy to decrease the incidence of postoperative urinary retention. Immediately before the elevating sutures are tied, a urethroscope is inserted into the midurethra and the bladder neck is visualized while the sutures are being tied with just enough tension to close the bladder neck. This resulted in a 100 per cent continence rate at twenty-four months and an average catheter time of 6.2 days, with 69 per cent of the patients voiding easily on the fourth postoperative day. This has resulted in a significant improvement over the length of catheter time when the urethroscope is not used, and additionally provides good experience and immediate feedback in a teaching situation for accuracy of suture placement and adequacy of bladder neck closure.

Urinary retention following operations for benign anorectal diseases.

Awareness of the problem of urinary retention following operations for benign anorectal diseases is essential in decreasing the incidence of bladder catheterization. A substantial decrease in the incidence of urinary retention in this study can be clearly attributed to fluid restriction—preoperatively, intraoperatively and postoperatively. Delaying catheterization until the bladder is obviously distended will help decrease the incidence of catheterization. Packing of the anorectum and type of anesthesia are not significant factors in the cause of urinary retention. Compared with other anorectal procedures, hemorrhoidectomy carries a higher incidence of postoperative urinary retention.