Non-drug conservative treatments for acute urinary retention after surgery in adults

Zhao, Shuo; Meng, Fan; Jin, Ying; Ma, Yue; Li, Wen Wen; Xun, Mi

doi:10.1002/14651858.cd011508

Cited by 1 publication

(2 citation statements)

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“…It included 15 RCTs and reported a significantly reduced risk of PO‐UR, consistent with the findings of the present review. There are also two published Cochrane protocols which are yet to be completed, one aimed at reviewing the evidence on drugs for the prevention of PO‐UR (2013) and the other on non‐drug treatments forPO‐UR (2015).…”

Section: Discussionmentioning

confidence: 99%

“…Multiple perioperative predictors have been proposed for the development of PO‐UR, including age, sex, type of anaesthesia and analgesia . The varying standards and definitions adopted by different studies, along with the multifactorial aetiology of PO‐UR, are reflected by the wide‐ranging reported incidence for this problem of between 5·7 and 69 per cent. Surgical populations at high risk of developing PO‐UR include joint arthroplasty (10·7–84 per cent), anorectal surgery (1–52 per cent), hernia repair (5·9–38 per cent) and gynaecological surgery (4–15 per cent).…”

Section: Introductionmentioning

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: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%