Postoperative urinary retention in patients undergoing elective spinal surgery

Area of Science:

• Neurosurgery
• Urology
• Anesthesiology

Background:

• Postoperative urinary retention (POUR) is a common complication following surgery, leading to increased morbidity and hospital stays.
• Limited data exists on the incidence and risk factors of POUR specifically in elective spinal surgery patients.

Purpose of the Study:

• To determine the incidence of POUR in patients undergoing elective spinal surgery.
• To identify patient and surgical factors associated with the occurrence of POUR.

Main Methods:

• Retrospective review of 397 patients undergoing elective spine surgery over 18 months.
• Prospective monitoring for POUR, collecting data on operative positioning, duration, fluid volume, and patient characteristics.
• Exclusion of dialysis patients and those with preoperative urinary retention.

Main Results:

• The incidence of POUR was 8.8% (35 out of 397 patients).
• Increased POUR incidence was associated with posterior lumbar surgery, benign prostatic hypertrophy (BPH), chronic constipation, prior urinary retention, and patient-controlled analgesia use.
• Longer operative time increased POUR risk, while intraoperative fluid volume did not. Female sex was also a risk factor after controlling for BPH.

Conclusions:

• Awareness of identified risk factors can aid perioperative Foley catheter management and patient monitoring.
• Identifying at-risk patients may help prevent prolonged hospital stays.
• Differentiating isolated POUR from urgent complications like epidural hematoma causing cauda equina syndrome is crucial for patient care.