Clin Orthop Surg.  2013 Jun;5(2):134-137. 10.4055/cios.2013.5.2.134.

Postoperative Urinary Retention Following Anterior Cervical Spine Surgery for Degenerative Cervical Disc Diseases

• Jung HJ
• Park JB
• Kong CG
• Kim YY
• Park J
• Kim JB

• KMID: 1705535
• DOI: http://doi.org/10.4055/cios.2013.5.2.134

Abstract

BACKGROUND
Postoperative urinary retention (POUR) may cause bladder dysfunction, urinary tract infection, and catheter-related complications. It is important to be aware and to be able to identify patients at risk of developing POUR. However, there has been no study that has investigated the incidence and risk factors for the development of POUR following anterior cervical spine surgery for degenerative cervical disc disease.
METHODS
We included 325 patients (164 male and 161 female), who underwent anterior cervical spine surgery for cervical radiculopathy or myelopathy due to primary cervical disc herniation and/or spondylosis, in the study. We did not perform en bloc catheterization in our patients before the operation.
RESULTS
There were 36 patients (27 male and 9 female) that developed POUR with an overall incidence of 11.1%. The mean numbers of postoperative in-and-out catheterizations was 1.6 times and mean urine output was 717.7 mL. Thirteen out of 36 POUR patients (36%) underwent indwelling catheterization for a mean 4.3 days after catheterization for in-and-out surgery, because of persisting POUR. Seven out of 36 POUR patients (19%) were treated for voiding difficulty, urinary tract irritation, or infection. Chi-square test showed that patients who were male, had diabetes mellitus, benign prostate hypertrophy or myelopathy, or used Demerol were at higher risk of developing POUR. The mean age of POUR patients was higher than non-POUR patients (68.5 years vs. 50.8 years, p < 0.01).
CONCLUSIONS
To avoid POUR and related complications as a result of anterior cervical spine surgery for degenerative cervical disc disease, we recommend that a catheter be placed selectively before the operation in at-risk patients, the elderly in particular, male gender, diabetes mellitus, benign prostate hypertrophy, and myelopathy. We recommend that Demerol not be used for postoperative pain control.

Keyword

Postoperative urinary retention; Anterior cervical spine surgery; Degenerative cervical disc diseases

MeSH Terms

Adult
Aged
Cervical Vertebrae/*surgery
Chi-Square Distribution
Diabetes Mellitus
Female
Humans
Intervertebral Disc Degeneration/*surgery
Male
Middle Aged
Postoperative Complications/etiology
Risk Factors
Urinary Catheterization
Urinary Retention/*etiology

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