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Updated: Oct 2, 2025

Transcorporal Artificial Urinary Sphincter Cuff Placement in a Case Requiring Revision for Urethral Atrophy
Published on: June 16, 2022
Postoperative Urinary Retention in Modern Rapid Recovery Total Joint Arthroplasty
Daniel N Bracey1, Kawsu Barry, Harpal S Khanuja
1From the Department of Orthopaedic Surgery, University of North Carolina, Chapel Hill, NC (Bracey), and the Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD (Barry, Khanuja, and Hegde).
Abstract:
Postoperative urinary retention (POUR) is a disruptive complication after modern rapid recovery total joint arthroplasty. This review aims to synthesize the recent literature on POUR in the setting of total joint arthroplasty. The incidence of POUR ranges from 5.5% to 46.3%. The lack of a standardized definition of POUR accounts for some of this variability. Risk factors previously associated with the development of POUR include increasing age, male sex, benign prostatic hyperplasia, use of bupivacaine and intrathecal morphine in spinal anesthesia, glycopyrrolate, and volume of intraoperative intravenous fluid administered. Predictive scoring assessments, such as the International Prostate Symptom Score and a newer predictive nomogram, have not been adequately validated by high-quality studies. The treatment of POUR comprises either intermittent or indwelling urethral catheterization. Higher quality prospective studies are needed to allow for the standardization of all aspects of POUR from its diagnostic criteria to its treatment.
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