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Prospective Observational Study to Evaluate Post-Operative Urinary Retention With Pediatric Epidural Analgesia
Ashish Sam Samuel1, Jujju Jacob Kurian1, Anita Shirley Joselyn2
1Department of Pediatric Surgery, Christian Medical College, Vellore, India.
Paediatric Anaesthesia
|May 19, 2026
Summary
Post-operative urinary retention (POUR) affects 10.2% of children receiving epidural analgesia, with older children and longer surgeries increasing risk. This suggests an age-guided approach to catheterization in pediatric epidural practice.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Urology
Background:
- Epidural analgesia is effective for pediatric post-operative pain.
- Post-operative urinary retention (POUR) significantly impacts recovery.
- Limited data exists on POUR in children receiving epidural analgesia.
Purpose of the Study:
- To investigate the incidence and risk factors of post-operative urinary retention (POUR) in children undergoing epidural analgesia.
- To address the data gap regarding POUR in pediatric patients receiving epidural pain management.
Main Methods:
- Prospective study in a pediatric surgery department.
- 157 children received epidural analgesia (Ropivacaine or Bupivacaine) during and after surgery.
- Ultrasound identified urinary retention, followed by catheterization if needed.
Main Results:
- Overall POUR incidence was 10.2% (16/157 children).
- Incidence increased with age (12.8% in ≥2 years vs. 0% in <2 years) and surgical duration.
- No significant difference in POUR based on opioid additives, anesthetic agent, or epidural level.
Conclusions:
- POUR incidence rises with age in pediatric patients receiving epidural analgesia.
- An age-guided, selective approach to bladder catheterization is recommended.
- Larger prospective studies are needed to establish evidence-based thresholds for catheterization.
