Urinary retention after total hip and knee arthroplasty

Area of Science:

• Anesthesiology
• Orthopedic Surgery
• Urology

Background:

• Postoperative urinary retention (POUR) is a common complication following lower joint arthroplasty, with reported incidence rates varying widely from 0% to 75%.
• Current management strategies for POUR include preoperative indwelling catheterization or postoperative intermittent catheterization, with ongoing debate regarding the optimal approach.
• Ultrasound-guided intermittent catheterization is increasingly recognized for potentially reducing POUR-related complications.

Purpose of the Study:

• To review existing literature on the influence of various analgesia techniques on the incidence of POUR after hip and knee arthroplasty.

Main Methods:

• Literature review of published data concerning postoperative urinary retention and analgesia strategies in arthroplasty patients.
• Analysis of the impact of general anesthesia, regional anesthesia, and different postoperative analgesic techniques on POUR development.

Main Results:

• Both general and regional anesthesia have been implicated in the etiology of POUR, but their type and duration do not show a clear correlation with incidence.
• Among the evaluated postoperative analgesic techniques, continuous peripheral nerve block demonstrated the least association with the development of POUR.

Conclusions:

• The choice of postoperative analgesia significantly influences the risk of developing postoperative urinary retention after hip and knee arthroplasty.
• Continuous peripheral nerve block appears to be a favorable option for pain management in arthroplasty patients aiming to minimize the risk of POUR.