Some observations on urinary retention and deep hip sepsis following total hip replacement

A follow-up study was made of 256 hip replacements, performed at Dunedin Hospital by three orthopaedic surgeons in males aged 45 years and over for the six year period beginning 1975 through to the end of 1980. One surgeon (A) had an elaborate management policy designed to reduce postoperative urinary retention and his cases are compared with Surgeon B's whose methods of avoiding urinary retention would be more representative of the majority of orthopaedic surgeons. Analysis was performed of the 20 cases of urinary retention pooled from all three participating surgeons. Also analysed were the 24 cases of epidural anaesthetics in the entire series. Surgeon A had a significantly (P=.045) lower postoperative urinary retention rate of 3.23% compared to surgeon B (12.07%). Analysis of the 20 cases of urinary retention revealed that cases having retention after previous operations and having nothing done about it invariably went into retention again. The retention rate after the 24 epidural anaesthetics was 16.7% and the retention rate after the 232 general anaesthetic cases was 6.9%. This difference was not statistically significant (p=0.10).