Postoperative urinary retention: Part II--A retrospective study

Postoperative urinary retention, a potential postoperative complication, can lead to discomfort and contribute to atony of bladder wall, need for catheterization and, sometimes, prolonged hospital stays. A retrospective study was conducted to analyze variables related to postoperative urinary retention. Data was collected by a chart review of 100 postoperative cases in a large Veterans Administration Medical Center. All patients were male, had a mean age of 61.1 years, and had received spinal or general anesthesia. Patients with known urologic problems, paraplegic patients, quadruplegic patients, patients undergoing procedures lasting less than 3 hours, and patients with indwelling Foley catheters were excluded. The medical review form was used to collect data from the medical records. Sixty-one percent of the patients required straight catheterization for their first postoperative urinary output. Sixty-five percent of the spinal anesthetic patients and 57% of the general anesthetic patients required straight catheterization. Orthopedic patients were the highest percentage of patients requiring catheterization. The patients who received large volumes of intravenous (IV) fluid in the operating room were more likely to be catheterized in the PACU. Determining whether physical assessment or IV volume indicated need for catheterization of these patients was difficult because documentation on the PACU record was usually incomplete. Complete documentation of assessment and intervention on the PACU record occurred 10% of the time. A need for full assessment on all postsurgical patients in the PACU and improved documentation is indicated.