Postoperative Urinary Retention is an Independent Predictor of Short-Term and Long-Term Future Bladder Outlet Procedure in Men

Abstract

In men 60 years old or older postoperative urinary retention identified those with an increased incidence of bladder outlet procedures within 3 years. Men younger than 60 years had a low rate of subsequent bladder outlet procedures regardless of a postoperative urinary retention diagnosis.

Urinary retention after non-urological surgeries: Management patterns and predictors of prognosis

“…Urinary retention is a prevalent clinical condition representing the reason for urology referral in 5%-25% of cases [8,9]. In our series, 5% of all urological consultations (inpatient and outpatient) were conducted due to POUR which is one of the main indications for bladder catheterization [10].…”

“…At 29 months follow-up, 1.855 (0.24%) patients underwent a bladder outlet procedure due to persistent urinary retention. They concluded that POUR after non-urological surgery increased the likelihood of a bladder outlet procedure within three years [8]. In our study, patients who underwent bladder outlet procedures during follow-up were excluded.…”

“…The hypotheses regarding the pathophysiology of POUR include decreased detrusor contractility due to general anesthetics and deteriorated autonomic nervous system, inhibition of perineal relaxation by lower abdominal pain, local inflammatory response following dissection through adjacent tissues and the difficulty of micturition due to immobility and/or positional limitations [11,12]. Additionally, ischemic processes and re-perfusion injuries as a result of bladder over-distention have been accepted to have negative effects on long term function of detrusor smooth muscle [8].…”

Preventing Postoperative Urinary Retention (POUR) in Patients Undergoing Elective Lumbar Surgery: A Quality Improvement Project

“…POUR contributes to increased health care costs and is associated with decreased patient satisfaction. 6,[8][9][10][11][12] Risks associated with indwelling urinary catheterization, such as catheter-associated uri- nary tract infections (CAUTI), contribute to significant mortality and morbidity. Over 13 000 deaths each year in the United States are associated with urinary tract infections, and CAUTIs can potentially progress to sepsis and endocarditis.…”

“…6,9 Morbidities include urinary tract infection, sepsis, bladder distension requiring self-catheterization, kidney injury, increased length of stay (LOS), wound infection, and venous thromboembolism. [10][11][12] POUR is also associated with decreased patient satisfaction. 8 A literature review identified early ambulation, early removal of indwelling catheters, and prophylactic tamsulosin as effective measures for preventing POUR.…”