Postoperative Urinary Retention After Bariatric Surgery: An Institutional Analysis

Area of Science:

• Bariatric Surgery
• Anesthesiology
• Urology

Background:

• Postoperative urinary retention (POUR) is a complication impacting patient outcomes and healthcare costs.
• The incidence and risk factors for POUR following bariatric surgery remain largely uncharacterized.
• Understanding POUR in this population is crucial for improving surgical quality and patient care.

Purpose of the Study:

• To determine the incidence of POUR in patients undergoing primary bariatric surgery.
• To identify specific risk factors associated with the development of POUR in this patient cohort.
• To inform strategies for reducing POUR and associated hospital stays.

Main Methods:

• Retrospective review of patients undergoing laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) between 2013 and 2017.
• POUR defined as inability to urinate postoperatively requiring catheterization.
• Univariate and multivariate analyses of perioperative variables to identify POUR correlations.

Main Results:

• Overall POUR incidence was 8.1% (49/603 patients).
• Laparoscopic sleeve gastrectomy (LSG) was associated with a significantly higher incidence of POUR compared to LRYGB (P=0.002).
• Independent risk factors for POUR included LSG, reduced intraoperative neostigmine and fluids, and isolated nondepolarizing muscle relaxants. Female patients with POUR had longer hospital stays.

Conclusions:

• Key risk factors for POUR after bariatric surgery include LSG, reduced intraoperative neostigmine and intravenous fluids, and specific muscle relaxants.
• Identifying these risk factors can guide patient and provider education.
• Targeting perioperative and anesthetic management strategies can potentially reduce POUR incidence and hospital length of stay.