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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Sex-Specific Differences and Risk Factors for Postoperative Urinary Retention after Spine Surgery with TIVA.

Ansun Jeong1,2, Mira Han3, Noah Hong1

  • 1Department of Neurosurgery, SNU Boramae Hospital, Seoul, Korea.

Journal of Korean Neurosurgical Society
|January 11, 2026
PubMed
Summary

Male patients undergoing spine surgery with total intravenous anesthesia (TIVA) face higher risks of postoperative urinary retention (POUR). Key risk factors include myelopathy, benign prostatic hyperplasia (BPH), and prolonged anesthesia time.

Keywords:
AnesthesiaRisk factorsSex characteristicsSpineSurgeryUrinary retention

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Area of Science:

  • Anesthesiology
  • Neurosurgery
  • Urology

Background:

  • Postoperative urinary retention (POUR) is a common complication after surgery.
  • Identifying sex-specific risk factors for POUR is crucial for targeted prevention strategies.
  • Total intravenous anesthesia (TIVA) is frequently used in spine surgeries, necessitating an understanding of its impact on POUR.

Purpose of the Study:

  • To determine sex-specific risk factors for POUR in patients undergoing spine surgery under TIVA.
  • To compare the incidence and risk factors of POUR between male and female patients.

Main Methods:

  • A retrospective chart review of 446 adult patients (268 males, 178 females) who underwent spine surgery with TIVA.
  • Propensity score matching was used to create a cohort of 328 patients (164 males, 164 females).
  • Multivariable logistic regression analysis identified independent risk factors for POUR, defined as residual urine volume ≥300 mL.

Main Results:

  • Male patients exhibited a higher incidence of POUR compared to females.
  • In males, significant risk factors for POUR included myelopathy (aOR, 5.17), benign prostatic hyperplasia (BPH) (aOR, 2.63), and prolonged anesthesia time ≥240 minutes (aOR, 2.54).
  • Myelopathy and prolonged anesthesia were associated with increased POUR risk in the overall population; no significant risk factors were identified in females.

Conclusions:

  • Male sex, myelopathy, BPH, and prolonged anesthesia time are significant risk factors for POUR after spine surgery with TIVA.
  • Male patients with myelopathy, a history of BPH, or prolonged anesthesia require heightened vigilance for POUR.