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Urinary retention after total hip replacement. A prospective study
The Journal of Bone and Joint Surgery. British Volume
|January 1, 1987
Summary
Acute urinary retention after hip replacement is predicted by pre-operative factors like difficulty urinating while lying down and signs of bladder obstruction. Early urological assessment for at-risk patients can prevent catheterization and infection risks.
Area of Science:
- Urology
- Orthopedic Surgery
- Anesthesiology
Background:
- Acute urinary retention (AUR) is a potential complication following total hip replacement (THR).
- Understanding pre-operative predictors of AUR is crucial for patient management and reducing complications.
- Catheterization, often used to manage AUR, carries risks such as deep vein thrombosis and surgical site infections.
Purpose of the Study:
- To prospectively identify pre-operative factors predicting acute urinary retention after total hip replacement in male patients.
- To inform pre-arthroplasty urological assessment and intervention strategies.
Main Methods:
- Prospective study of 103 consecutive male patients undergoing total hip replacement.
- Pre-operative assessment included evaluating ability to void in bed, urinary peak-flow rates, and history of bladder outflow issues.
- Post-operative monitoring for acute urinary retention.
Main Results:
- Eleven patients (10.7%) developed acute urinary retention post-operatively.
- Three pre-operative factors demonstrated predictive value: inability to pass urine into a bottle while lying down, urinary peak-flow rates indicating obstruction, and a history of previous bladder outflow problems.
Conclusions:
- Patients with pre-operative indicators of potential urinary retention should undergo urological assessment before hip arthroplasty.
- Proactive urological management can mitigate the need for post-operative catheterization and associated infection risks.