Early Ambulation Reduces the Incidence of Urinary Retention after Spinal Anesthesia for Benign Anorectal Surgery

Kim, Seong Bae; Kong, Myung Hoon; Lee, Mi Gyeong; Kim, Nan Sook; Choi, Young Seok; Lim, Sang Ho

doi:10.4097/kjae.1999.37.6.1001

Cited by 2 publications

(6 citation statements)

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“…High‐certainty evidence was found for an association between early mobilization and reduced incidence of PO‐UR (summary OR 0·35, 95 per cent c.i. 0·21 to 0·57; I 2 = 0 per cent; 2 trials) , . There was no evidence for an effect of early mobilization on pain (1 trial).…”

Section: Resultsmentioning

confidence: 98%

“…After removal of duplicate records, 6415 reports were identified of which 48 studies (5644 participants) were included in the review ( Fig . ).…”

Section: Resultsmentioning

confidence: 99%

“…Eleven , , , , were judged at high risk of bias; these studies evaluated pharmacological (7 studies) and non‐pharmacological (3) interventions for the prevention of PO‐UR, and a pharmacological intervention (1 study) for the treatment of PO‐UR. There were 27 studies , , , , , , , rated as having some concerns; these studies evaluated pharmacological (16 studies) and non‐pharmacological (5) interventions for the prevention of PO‐UR, and pharmacological (2) and non‐pharmacological (4) interventions for treating PO‐UR.…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of interventions for the prevention and treatment of postoperative urinary retention

et al. 2018

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BackgroundPostoperative urinary retention (PO‐UR) is an acute and painful inability to void after surgery that can lead to complications and delayed hospital discharge. Standard treatment with a urinary catheter is associated with a risk of infection and can be distressing, undignified and uncomfortable. This systematic review aimed to identify effective interventions for the prevention and treatment of PO‐UR that might be alternatives to urinary catheterization.MethodsElectronic databases were searched from inception to September 2017. Randomized trials of interventions for the prevention or treatment of PO‐UR were eligible for inclusion. Studies were assessed for risk of bias using the Cochrane (2.0) tool. Two reviewers were involved at all review stages. Where possible, data were pooled using random‐effects meta‐analysis. The overall quality of the body of evidence was rated using the GRADE approach.ResultsSome 48 studies involving 5644 participants were included. Most interventions were pharmacological strategies to prevent PO‐UR. Based on GRADE, there was high‐certainty evidence to support replacing morphine in a regional anaesthetic regimen, using alpha‐blockers (number needed to treat to prevent one case of PO‐UR (NNT) 5, 95 per cent c.i. 5 to 7), the antispasmodic drug drotaverine (NNT 9, 7 to 30) and early postoperative mobilization (NNT 5, 4 to 8) for prevention, and employing hot packs or gauze soaked in warm water for treatment (NNT 2, 2 to 4). Very few studies reported on secondary outcomes of pain, incidence of urinary tract infection or duration of hospital stay.ConclusionPromising interventions exist for PO‐UR, but they need to be evaluated in randomized trials investigating comparative clinical and cost effectiveness, and acceptability to patients.

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Section: Resultsmentioning

confidence: 98%

“…After removal of duplicate records, 6415 reports were identified of which 48 studies (5644 participants) were included in the review ( Fig . ).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Systematic review of interventions for the prevention and treatment of postoperative urinary retention

et al. 2018

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“…DMA was performed according to five outcomes, that is, POUR (39 studies, n = 4,697), PVRU (five studies, n = 490), UTI (four studies, n = 326), LUTS (three studies, n = 437) and AE (19 studies, n = 1949). For POUR, 39 studies were included with 4/6 pairs of interventions 17 , 18 , 20 , 21 , 23 , 26 , 28 , 30 – 32 , 35 – 56 , 60 – 63 which were significant in the incidence of POUR relative to PLA, that is, AMB ( n = 398), ACU ( n = 325), OPI ( n = 429) and ALP ( n = 5206) with the pooled RR [95% confidence interval (CI)] of 0.44 (0.32, 0.61), 0.32 (0.11, 0.94), 0.62 (0.40, 0.95) and 0.55 (0.40, 0.76), respectively ( Supplemental Figure 2 ). The heterogeneity was varied with the I 2 ranged from 63.54 to 73.34.…”

Section: Resultsmentioning

confidence: 99%

“…In terms of AE, 23 studies reported AE but only 19 studies of three comparisons which had at least three studies in each comparison were included in the analysis. 17 , 18 , 30 – 32 , 61 , 62 Among these, overall and individual AEs were reported in 10 and nine studies ( Supplemental Table 2 ). 38 , 40 , 41 , 44 , 48 – 52 , 54 – 56 , 60 For those reported individual AEs, we used the maximum incidence of individual AE as the composite outcome.…”

Section: Resultsmentioning

confidence: 99%

Medical and non-medical interventions for post-operative urinary retention prevention: network meta-analysis and risk–benefit analysis

Sirisreetreerux

Wattanayingcharoenchai

Rattanasiri

et al. 2021

Therapeutic Advances in Urology

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Aims: To assess the efficacy in lowering post-operative urinary retention, urinary tract infection and lower urinary tract symptoms and the incidence of adverse events among 12 interventions and to perform risk–benefit analysis. Methods: Previous randomized controlled trials were identified from MEDLINE, Scopus and CENTRAL database up to January 2020. The interventions of interest included early ambulation, fluid adjustment, neuromodulation, acupuncture, cholinergic drugs, benzodiazepine, antispasmodic agents, opioid antagonist agents, alpha-adrenergic antagonists, non-steroidal anti-inflammatory drugs (NSAIDs) and combination of any interventions. The comparators were placebo or standard care or any of these interventions. Network meta-analysis was performed. The probability of being the best intervention was estimated and ranked using rankogram and surface under the cumulative ranking curve. Risk–benefit analysis was done. Incremental risk–benefit ratio (IRBR) was calculated and risk–benefit acceptability curve was constructed. Results: A total of 45 randomized controlled trials with 5387 patients was included in the study. Network meta-analysis showed that early ambulation, acupuncture, alpha-blockers and NSAIDs significantly reduced the post-operative urinary retention. Regarding urinary tract infection and lower urinary tract symptoms, no statistical significance was found among interventions. Regarding the side effects, only alpha-adrenergic antagonists significantly increased the adverse events compared with acupuncture and opioid antagonist agents from the indirect comparison. According to the cluster ranking plot, acupuncture and early ambulation were considered high efficacy with low adverse events, corresponding to the IRBR. Conclusion: Early ambulation, acupuncture, opioid antagonist agents, alpha-adrenergic antagonists and NSAIDs significantly reduce the incidence of post-operative urinary retention with no difference in adverse events. Regarding the risk–benefit analysis of the medical treatment, alpha-adrenergic antagonists have the highest probability of net benefit at the acceptable threshold of side effect of 15%, followed by opioid antagonist agents, NSAIDs and cholinergic drugs.

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Early Ambulation Reduces the Incidence of Urinary Retention after Spinal Anesthesia for Benign Anorectal Surgery

Cited by 2 publications

References 0 publications

Systematic review of interventions for the prevention and treatment of postoperative urinary retention

Systematic review of interventions for the prevention and treatment of postoperative urinary retention

Medical and non-medical interventions for post-operative urinary retention prevention: network meta-analysis and risk–benefit analysis

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