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Routine Indwelling Urinary Catheterization Is Not Necessary During Total Hip Arthroplasty Performed Under Spinal

Kurtis D Carlock1, Zachary D Mills1, Kyle W Geiger1

  • 1Department of Orthopaedic Surgery and Sports Medicine, University of Washington, Seattle, WA, USA.

Arthroplasty Today
|June 6, 2022
PubMed

Insights

Routine urinary catheterization after hip surgery under spinal anesthesia is often unnecessary. It may increase urinary tract infection risk without reducing major retention, suggesting it should be avoided to improve patient outcomes.

Area of Science:

  • Urology
  • Orthopedic Surgery
  • Anesthesiology

Background:

  • Perioperative urinary catheterization is common in total hip arthroplasty (THA).
  • The necessity of routine catheterization following THA under spinal anesthesia requires investigation regarding urinary complications.

Purpose of the Study:

  • To evaluate the impact of routine indwelling urinary catheterization post-THA under spinal anesthesia.
  • To determine the effect on the incidence of urinary complications, including postoperative urinary retention (POUR).

Main Methods:

  • Retrospective review of 991 patients undergoing primary THA under spinal anesthesia.
  • Comparison of outcomes between patients with and without routine indwelling urinary catheterization.
  • Definition of minor POUR (resolved with 1-2 catheterizations) and major POUR (requiring indwelling catheter placement).

Main Results:

  • Routine catheterization was linked to a higher rate of urinary tract infections (1.4% vs 0.0%).
  • A lower rate of minor POUR was observed in the routine catheterization group (5.0% vs 10.3%).
  • No significant difference was found in major POUR or discharge with a catheter; multivariate analysis confirmed an association with lower minor POUR but not overall or major POUR.

Conclusions:

  • Routine indwelling urinary catheterization may not be necessary for THA patients under spinal anesthesia.
  • The practice might increase the risk of urinary tract infections without significant benefits in preventing major urinary retention.
Abstract

Keywords:
Foley catheterizationSpinal anesthesiaTotal hip arthroplastyUrinary catheterizationUrinary retention

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