Korean J Urol.  2007 Dec;48(12):1277-1284. 10.4111/kju.2007.48.12.1277.

Analysis of Risk Factors for Acute Urinary Retention after Non-urogenital Surgery

• Lee SJ
• Kim YT
• Lee TY
• Woo YN

• KMID: 1990151
• DOI: http://doi.org/10.4111/kju.2007.48.12.1277

Abstract

PURPOSE: We performed this study to analyze the risk factors that are related to acute urinary retention in patients undergoing non-urogenital surgery.
MATERIALS AND METHODS
We retrospectively analyzed the records of 127 patients who were referred to the urology department because of acute urinary retention after non-urogenital surgery at our institution between January 2004 and December 2005, and we also recuited 258 consecutive patients who were undergoing non-urogenital surgery at our institution during the same period as a control group. Multiple parameters were divided into patient factors, surgical factors and anesthetic factors, and these factors were analyzed using univariate and multivariate regression analyses between the non-retention and the retention groups.
RESULTS
On the multivariate analysis, age(> or =50 years, p=0.037; odds ratio (OR)=2.8), gender(women, p=0.028; OR=2.5), comorbidity with diabetes mellitus(p=0.003; OR=5.8) were found to independently increase the risk of acute urinary retention. After re-adjustment for the patients' gender, age, body mass index, diabetes, hypertension, the inability to self-ambulate after the removal of a Foley catheter(p=0.001; adjusted odds ratio (AOR)= 3.8), the amount of intraoperative fluids(> or =4,000ml, p=0.017; AOR=4.8) were found to independently increase the risk of acute urinary retention.
CONCLUSIONS
The possibility of acute urinary retention for patients undergoing non-urogenital surgery and who have these risk factors is high; therefore, carefully managing urination for the prevention of postoperative acute urinary retention is needed. It is also necessary to make doctors in other departments recognize the importance of this issue.

Keyword

Acute; Urinary retention; Surgery

MeSH Terms

Body Mass Index
Comorbidity
Humans
Hypertension
Multivariate Analysis
Odds Ratio
Retrospective Studies
Risk Factors*
Urinary Retention*
Urination
Urology

Reference

1. Wein AJ. Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Lower urinary tract dysfunction in neurologic injury and disease. Campbell's urology. 2007. 9th ed. Philadelphia: Saunders;2040–2041.

2. Mayo MP, Lloyd-Davies RW, Schuttleworth KE, Tighe JR. The damaged human detrusor: functional and electron microscopic changes in disease. Br J Urol. 1973. 15:116–125.

3. Hinman F. Postoperative overdistention of the bladder. Surg Gynecol Obstet. 1976. 142:901–902.

4. Wren KR, Wren TL. Postsurgical urinary retention. Urol Nurs. 1996. 16:45–49.

5. Campbell ED. Prevention of urinary retention after anorectal operations. Dis Colon Rectum. 1972. 15:69–70.

6. Kemp D, Tabaka N. Postoperative urinary retention: Part II--a retrospective study. J Post Anesth Nurs. 1990. 5:397–400.

7. Orko R, Rosenberg PH. Comparison of some postanaesthetic effects of atropine and glycopyrrolate with particular emphasis on urinary problems. Acta Anaesthesiol Scand. 1984. 28:112–115.

8. Prasad ML, Abcarian H. Urinary retention following operations for benign anorectal diseases. Dis Colon Rectum. 1978. 21:490–492.

9. Lee EO, Seo MJ, Kim MJ, Kim CS, Han KJ, Park YS, et al. Nursing diagnosis and intervention. 1997. 5th ed. Seoul: Seoul National University press;206–211.

10. Petros JG, Rimm EB, Robillard RJ. Factors influencing urinary tract retention after elective open-cholecystectomy. Surg Gynecol Obstet. 1992. 174:497–500.

11. Voith AM, Smith DA. Validation of the nursing diagnosis of urinary retention. Nurs Clin North Am. 1985. 20:723–729.

12. Stallard S, Prescott S. Postoperative urinary retention in general surgical patients. Br J Surg. 1988. 75:1141–1143.

13. Kwon MI, Kim KM, Kim KW, Kim BK, Kim SY, Kim SD, et al. Anesthesiology. 2005. 3rd ed. Seoul: Ryomoongak;119–112.

14. Petros JG, Rimm EB, Robillard RJ, Argy O. Factors influencing postoperative urinary retention in patients undergoing elective inguinal herniorrhaphy. Am J Surg. 1991. 161:431–433.

15. Koch CA, Grinberg GG, Fairley DR. Incidence and risk factors for urinary retention after endoscopic hernia repair. Am J Surg. 2006. 191:381–385.

16. Petros JG, Alameddine F, Testa E, Rimm EB, Robillard RJ. Patient-controlled analgesia and postoperative urinary retention after hysterectomy for benign disease. J Am Coll Surg. 1994. 176:663–667.

17. Hozack WJ, Carpiniello V, Booth RE Jr. The effect of early bladder catheterization on the incidence of urinary complications after total joint replacement. Clin Orthop Relat Res. 1988. 231:79–82.

18. Michelson JD, Lotke PA, Steinberg ME. Urinary-bladder management after total joint replacement surgery. N Eng J Med. 1988. 319:321–326.

19. Carpiniello VL, Cerdron M, Altman HG, Mallory TR, Booth R. Treatment of urinary complications after total joint replacement in elderly females. Urology. 1988. 32:186–190.

20. Lau H, Lam B. Management of postoperative urinary retention: a randomized trial of in-out versus overnight catheterization. ANZ J Surg. 2004. 74:658–661.

21. Wald H, Epstein A, Kramer A. Extended use of indwelling urinary catheters in postoperative hip fracture patients. Med Care. 2005. 43:1009–1017.

22. Tammela T, Kontturi M, Lukkarinen O. Postoperative urinary retention. I. Incidence and predisposing factors. Scand J Urol Nephrol. 1986. 20:197–201.

23. Husted S, Djurhuus JC, Hasegaard HC, Jepsen J, Mortensen J. Effect of postoperative extradural morphine on lower urinary tract function. Acta Anaesthesiol Scand. 1985. 29:183–185.

24. Lanz E, Theiss D, Reiss W, Sommer U. Epidural morphine for postoperative analgesia: a double-blind study. Anesth Analg. 1982. 61:236–240.