Postoperative Urinary Retention After General Surgical Procedures: Incidence, Risk Factors, and Short-Term Outcomes

Postoperative urinary retention (POUR) is a frequent but sometimes missed complication after general surgical procedures. If not recognized early, it may cause bladder overdistension, patient discomfort, urinary tract infection, unexpected catheterization, delayed mobilization and longer hospital stay. This study was conducted to determine the incidence, associated risk factors, and short-term outcomes of POUR in patients undergoing general surgical procedures.

This prospective observational study included adult patients who underwent elective or emergency general surgical procedures under spinal, regional, or general anesthesia. Patients with pre-existing urinary retention, chronic catheterization, neurogenic bladder, or known obstructive uropathy were excluded. POUR was defined as failure to void within six to eight hours after surgery, associated with suprapubic discomfort, bladder distension, or bladder volume requiring catheterization. Data regarding demographic profile, comorbidities, type and duration of surgery, anesthetic technique, perioperative intravenous fluid volume, postoperative opioid use, and early postoperative outcomes were recorded and analyzed.

A total of 220 patients were included in the study. POUR developed in 32 patients (14.5%), while 188 patients (85.5%) did not develop urinary retention. POUR was more common in patients aged above 60 years (16/63 (25.4%)) than in those aged 60 years or below (16/157 (10.2%)). Male patients had a higher frequency of POUR (22/112 (19.6%)) compared with female patients (10/108 (9.3%)). Higher occurrence was also observed among patients with diabetes mellitus (12/50 (24.0%)), lower urinary tract symptoms (10/30 (33.3%)), spinal anesthesia (21/89 (23.6%)), operative duration >90 minutes (17/65 (26.2%)), perioperative intravenous fluid administration >1500 mL (20/83 (24.1%)) and postoperative opioid use (23/105 (21.9%)). Patients who developed POUR had higher rates of repeated catheterization, urinary tract infection, delayed mobilization, catheter-related discomfort, and longer hospital stay.

POUR is an important early postoperative complication in general surgical patients. Advanced age, male sex, diabetes mellitus, pre-existing lower urinary tract symptoms, spinal anesthesia, prolonged surgery, higher perioperative fluid administration, and postoperative opioid use were associated with increased risk. Careful preoperative risk assessment, early bladder monitoring, and timely intervention may help reduce catheter-related morbidity and support smoother postoperative recovery.