[Postoperative urinary retention]

In 359 patients 371 operations were performed under general or regional anesthesia, and these were followed up with regard to anesthesiological technique, postoperative course and voiding of the bladder. Patients under 15 years of age, with severe incontinence or with a bladder catheter were excluded from the study. The surgical specialties were general surgery, orthopaedics, gynecology, ENT and ophthalmology. If any patient had not urinated by 6-10 h postoperatively and was found to have a full bladder on palpation, urinary retention was diagnosed. There were 75 patients (20%) who had urinary retention, significantly fewer women than men (p less than 0.025), and men under 35 years old had significantly less retention than older men (p less than 0.0025). The anesthesiological technique is an important factor in postoperative urinary retention: spinal anesthesia with tetracaine and adrenaline caused significantly more retention than spinal anesthesia with lidocaine 5% (p less than 0.005), and more than epidural or general anesthesia (p less than 0.005). No significant difference concerning urinary retention was found regarding surgical specialty, emergency operations, morphine or adrenaline added to tetracaine for spinal anesthesia, amount of local anesthetics used for epidural anesthesia or between spinal anesthesia with lidocaine 5% and epidural anesthesia with mepivacaine. Once urinary retention is diagnosed, conservative (privacy, relaxation exercises, getting up) or medical treatment (propyphenazone + hexahydroadiphenine (Spasmocibalgin), carbamoyl choline chloride) should be given. Catheterization should be performed only as a last resort.