Risk Factors for Postoperative Urinary Retention Following Lumbar Spine Surgery: A Review of Current Literature and Meta-Analysis

Reed, Logan A.; Mihas, Alexander; Fortin, Travis A; Donley, Connor J; Pratheep, Guna; Manoharan, Sakthivel Rajaram; Theiss, Steven M.; Viswanathan, Vibhu Krishnan

doi:10.1177/21925682221146493

Cited by 4 publications

(1 citation statement)

References 43 publications

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“…Urinary retention is a common complication after lumbar surgery, which may be quite painful for patients, and it further increases the risk of infection because a few patients need to insert catheters for a long time because of urinary retention. [ 12 , 13 ] For patients with long-term indwelling sterile catheter, the drainage tube should be opened once every 4–6 hours, and bladder irrigation should be carried out twice a day with sterile injection water or boric acid solution to prevent infection. When patients stay in bed for a long time, family members and medical staff need to help patients turn over, pat their backs and move their paralyzed limbs passively, which can effectively prevent pressure ulcers, falling pneumonia and deep venous thrombosis of lower limbs and promote the recovery of patients’ condition.…”

Section: Discussionmentioning

confidence: 99%

Iagnosis and treatment of myelitis after lumbar reoperation: A case report

Li,

Chen,

Zhang

et al. 2023

Medicine

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Rationale: At present, acute myelitis (AM) is a great challenge to diagnosis and treatment because of its complicated etiology, critical condition, and poor prognosis, and it is easy to leave different degrees of limb motor dysfunction. The report of this case is helpful to improve the understanding of AM after lumbar surgery, reduce misdiagnosis and provide reference for clinical treatment. Patient’s concern: This study reported a case of AM after lumbar reoperation. Before the patient was diagnosed as AM, we gave high-dose hormone anti-inflammatory and detumescence symptomatic treatment according to empirical treatment, and the effect was ideal and rehabilitation treatment was actively carried out at the right time. After 10 months of follow-up, the patient recovered well. Diagnosis: Because lumbar surgery is a contraindication of lumbar puncture, the patient’s diagnosis was confirmed by thoracic magnetic resonance imaging. Magnetic resonance imaging of thoracic vertebra on the 17th day after lumbar operation showed that small round T1W1 signal, slightly higher T2W1 signal and T2-fat suppression imaging equal signal were seen in the horizontal spinal cord of thoracic vertebra 10. Intervention: According to the empirical treatment, patients have been given high-dose hormone therapy after operation, and comprehensive treatment such as comprehensive training of paraplegic limbs, joint loosening training, electric massage and other rehabilitation training will be carried out when the general condition of patients improves. Outcomes: After 10 months of follow-up, there were no major sequelae such as limb paralysis. Conclusion: Due to the rarity of AM in clinical work, it is easy for doctors to ignore the disease and miss the best treatment stage, which will lead to serious sequelae.

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Section: Discussionmentioning

confidence: 99%

Iagnosis and treatment of myelitis after lumbar reoperation: A case report

Li,

Chen,

Zhang

et al. 2023

Medicine

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Preoperative tamsulosin effect on postoperative urinary retention following spinal surgery: A randomized controlled trial

Haddadi,

Ahmadi,

Kerigh

et al. 2023

International Journal of Surgery Open

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Background Current study aims to investigate pre-surgical medical intervention on the reduction of POUR incidence in patients undergoing spine surgery. Method The study was a single center double-blind randomized placebo clinical trial. Participants were individuals over 18 years old who underwent spinal surgery at the Educational and Therapeutic Hospital between 2020 and 2023. Inclusion criteria included the ability to provide informed consent and follow the study schedule, while exclusion criteria included certain medical conditions, current medication use, and inability to take oral medication after surgery. Results The study enrolled 100 patients. There was no significant difference in age or gender distribution between the tamsulosin and placebo groups, but the tamsulosin group had a lower prevalence of diabetes. The duration of surgery was shorter in the tamsulosin group, and there was no significant difference in the surgical site. The tamsulosin group had significantly less post-void residual volume on the eighth day of the study, but there were no significant differences in urine output volume during surgery or residual urine volume before or after surgery. Conclusion Tamsulosin may be effective in preventing postoperative urinary retention (POUR), but its effectiveness in treating established POUR is uncertain. The Tamsulosin group had significantly lower post-void residual volume after spine surgery. Considering the low risk of adverse effects, Tamsulosin could be considered for high-risk patients. However, patients should be aware of potential risks and seek medical attention if they experience adverse effects. Further research is needed to determine the best dosage and duration of treatment. Highlights

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Risk Factors for de Novo Postoperative Urinary Retention in Posterior Lumbar Spine Surgery

Nakajima,

Honjoh,

Watanabe

et al. 2024

Global Spine Journal

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Study Design Retrospective cohort study. Objective De novo postoperative urinary retention (POUR) after lumbar posterior decompression surgery for lumbar spinal canal stenosis (LSCS) is a statistically known but uncommon complication for both patients and spine surgeons. The aim of this study is to review clinical data and imaging findings and identify preoperative predictors of de novo POUR. Methods The subjects were 738 surgically treated patients with LSCS, without preoperative bladder dysfunction or perioperative complications. Univariate and multivariate analyses using propensity score matching were performed to identify prognostic factors for POUR lasting for at least 1 week after postoperative urinary catheter removal. Results POUR occurred in 23 patients (3.1%). The median recovery time was 41 days and only 12 patients (52.2%) showed improvement within 3 months. Patients with POUR were significantly older, and the lumbar Cobb angle, location of compressed dura mater (ventral or dorsal), and type of cauda equina redundancy (curve-type) were identified as independent prognostic factors. POUR had no association with sex, comorbidities, surgical procedures, number of decompressed segments, or degree of dura mater compression. Conclusions This study suggests that older age and curve-type stenosis with ventral or dorsal compression of the dura mater are risk factors for development of de novo POUR. Such preoperative imaging findings may indicate a higher risk of intraoperative thermal and nerve injuries, and possible uneven cauda equina flow improvement after decompression.

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Risk Factors for Postoperative Urinary Retention Following Lumbar Spine Surgery: A Review of Current Literature and Meta-Analysis

Cited by 4 publications

References 43 publications

Iagnosis and treatment of myelitis after lumbar reoperation: A case report

Iagnosis and treatment of myelitis after lumbar reoperation: A case report

Preoperative tamsulosin effect on postoperative urinary retention following spinal surgery: A randomized controlled trial

Risk Factors for de Novo Postoperative Urinary Retention in Posterior Lumbar Spine Surgery

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