You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Non-neurogenic Voiding Dysfunction1 Apr 20131956 LATE URINARY RETENTION AMONG ELDERLY WOMEN WHO UNDERWENT HIP ARTHROPLASTY: A PROSPECTIVE EVALUATION UPON ADMISSION TO REHABILITATION Asnat Groutz, Victor Shvedov, and Dan Justo Asnat GroutzAsnat Groutz Tel Aviv, Israel More articles by this author , Victor ShvedovVictor Shvedov Tel Aviv, Israel More articles by this author , and Dan JustoDan Justo Tel Aviv, Israel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2375AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Acute symptomatic postoperative urinary retention among elderly women who underwent hip arthroplasty is quite common. However, there is no data regarding late, usually asymptomatic, urinary retention among these patients. The aim of our study was to assess the incidence of late urinary retention among elderly women who underwent hip arthroplasty. METHODS 100 consecutive elderly (≥65 years; mean age 82.3) women who underwent hip arthroplasty and postoperative rehabilitation at one university-affiliated medical center were prospectively enrolled. Women were evaluated and followed-up through their inpatient rehabilitation. The mean interval between surgery to rehabilitation admission was 11.5±5.9 days. Those already with urinary catheter upon rehabilitation admission, or with moderate to severe cognitive decline, were excluded. Post-voiding residual urinary volume (PVR) measurements were undertaken by using a portable ultrasound bladder scan (BVI 3000). Urinary retention was defined as PVR≥200mL in repeated measurements. Women with PVR≥700mL were treated by transurethral catheterization until resumption of normal PVR. All other patients were clinically observed. Clinical and lab parameters were analyzed and compared between women with versus without urinary retention. RESULTS Urinary retention was diagnosed in 38 (38%) women, with mean PVR of 549±388mL. Most women (N=33, 87%) were asymptomatic. Eleven (11%) women had PVR≥700mL (mean 1033±283mL), most of whom (N=10, 91%) were asymptomatic. Univariate comparison of women with versus without urinary retention is presented in Table. Baseline Albumin and TSH values, as well as the use of antimuscarinic or narcotic drugs, were found to be significantly more common among women with urinary retention. However, on multivariate model, only the use of narcotics was found to be significant independent risk factor (OR 50.3, 95% CI 14.7;171.6). Rehabilitation outcomes were similar in women with and without urinary retention, and all but 3 achieved normal PVR by rehabilitation completion. CONCLUSIONS The main risk factor for late urinary retention among elderly women who underwent hip arthroplasty is the use of narcotics. Use of non-narcotic analgesic drugs is therefore strongly recommended in these patients. Comparison of women with (N=38) versus without (N=62) urinary retention MEAN+SD; or N (%) PVR < 200mL PVR > 200mL P value PVR (mL) 63+58 549+388 0.0001 AGE (years) 81.7+6.6 83.5+5.9 0.172 PARITY 2.1+1.5 1.9+1.2 0.412 HYPERTENSION 45 (73%) 32 (84%) 0.137 DIABETES 13 (21%) 9 (24%) 0.804 IHD 12 (19%) 10 (26%) 0.455 S/P CVA 4 (6%) 5 (13%) 0.288 MILD DEMENTION 21 (34%) 16 (42%) 0.395 DEPRESSION 18 (29%) 17 (45%) 0.128 PARKINSON 6 (10%) 1 (3%) 0.252 HYPOTHYROIDISM 5 (8%) 2 (5%) 0.709 COPD 11 (18%) 6 (16%) 0.999 MMSE score 24.8+3.1 23.9+2.8 0.155 ALBUMIN (mg%) 34.3+4.4 32.4+4.0 0.034 CRP (mg%) 30.9+22.2 37.3+25.3 0.201 CREATININE (mg%) 1.5+0.7 0.9+0.2 0.685 HB (Gr%) 11.2+3.9 10.4+1.1 0.550 FOLIC ACID (ng/mL) 9.2+5.9 9.3+6.4 0.772 TSH (mIU/L) 4.7+5.3 3.4+5.3 0.032 B12 (pg/mL) 523+355 519+282 0.265 ANTIMISCARINIC Drugs 7 (11%) 18 (47%) 0.0001 NARCOTIC Drugs 7 (11%) 32 (84%) 0.0001 REHABILITATION (days) 25.7+15.5 23.9+15.8 0.868 © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e802 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Asnat Groutz Tel Aviv, Israel More articles by this author Victor Shvedov Tel Aviv, Israel More articles by this author Dan Justo Tel Aviv, Israel More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...