Urinary Retention Following Non-urologic Surgery

Nevo, Amihay; Haidar, Abdul Muhsin; Navaratnam, Anojan; Humphreys, Mitchell R.

doi:10.1007/s11884-019-00518-7

“…It can cause urethral trauma, discomfort and urinary tract infection. On the other hand, bladder overdistention can cause temporary or even permanent damage to the lower urinary tract (LUT) (Choi & Awad, 2013;Brouwer et al, 1999;Mason et al, 2016;Nevo et al, 2019). LUT dysfunction can vary from mild (frequent voiding ) to moderate (recurrent urinary tract infections) and can lead to severe adverse events (permanent bladder damage ending in lifelong self-catheterization) (Dreyer et al, 2011;Umer et al, 2015;Wu et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Postoperative urinary retention: risk factors, bladder filling rate and time to catheterization: an observational study as part of a randomized controlled trial

Brouwer

¹

,

Roon

²

,

Kalkman

³

et al. 2021

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Background Knowledge of risk factors for postoperative urinary retention may guide appropriate and timely urinary catheterization. We aimed to determine independent risk factors for postoperative urinary catheterization in general surgical patients. In addition, we calculated bladder filling rate and assessed the time to spontaneous voiding or catheterization. We used the patients previously determined individual maximum bladder capacity as threshold for urinary catheterization. Methods Risk factors for urinary catheterization were prospectively determined in 936 general surgical patients. Patients were at least 18 years of age and operated under general or spinal anesthesia without the need for an indwelling urinary catheter. Patients measured their maximum bladder capacity preoperatively at home, by voiding in a calibrated bowl after a strong urge that could no longer be ignored. Postoperatively, bladder volumes were assessed hourly with ultrasound. When patients reached their maximum bladder capacity and were unable to void, they were catheterized by the nursing staff. Bladder filling rate and time to catheterization were determined. Results Spinal anesthesia was the main independent modifiable risk factor for urinary catheterization (hyperbaric bupivacaine, relative risk 8.1, articaine RR 3.1). Unmodifiable risk factors were a maximum bladder capacity < 500 mL (RR 6.7), duration of surgery ≥ 60 min (RR 5.5), first scanned bladder volume at the Post Anesthesia Care Unit ≥250mL (RR 2.1), and age ≥ 60 years (RR 2.0). Urine production varied from 100 to 200 mL/h. Catheterization or spontaneous voiding took place approximately 4 h postoperatively. Conclusion Spinal anesthesia, longer surgery time, and older age are the main risk factors for urinary retention catheterization. Awareness of these risk factors, regularly bladder volume scanning (at least every 3 h) and using the individual maximum bladder capacity as volume threshold for urinary catheterization may avoid unnecessary urinary catheterization and will prevent bladder overdistention with the attendant risk of lower urinary tract injury. Trial registration Dutch Central Committee for Human Studies registered trial database: NL 21058.099.07. Current Controlled Trials database: Preventing Bladder Catheterization after an Operation under General or Spinal Anesthesia by Using the Patient’s Own Maximum Bladder Capacity as a Limit for Maximum Bladder Volume. ISRCTN97786497. Registered 18 July 2011 -Retrospectively registered. The original study started 19 May 2008, and ended 30 April 2009, when the last patient was included.

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“…Contudo, o tratamento precoce e correto evita complicações da distensão excessiva da bexiga, como danos temporários e permanentes do trato urinário (NEVO et al, 2019). Assim, o quadro pode evoluir para injúria renal aguda, falência do músculo detrusor e infecções recorrentes (UMER et al, 2015).…”

Section: Retenção Urináriaunclassified

Fármacos Potencialmente Inapropriados Para Idoso

Pereira,

Costa,

Souza

et al. 2024

Urgências E Emergências Geriátricas: Clínicas E Cirúrgicas

0

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“…Contudo, o tratamento precoce e correto evita complicações da distensão excessiva da bexiga, como danos temporários e permanentes do trato urinário (NEVO et al, 2019). Assim, o quadro pode evoluir para injúria renal aguda, falência do músculo detrusor e infecções recorrentes (UMER et al, 2015).…”

Section: Retenção Urináriaunclassified