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Bladder management after total joint arthroplasty

R M Knight1, V D Pellegrini

  • 1Department of Orthopaedics and Rehabilitation, Pennsylvania State University College of Medicine, Hershey 17033, USA.

The Journal of Arthroplasty
|December 1, 1996
PubMed
Summary
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Indwelling Foley catheters are a cost-effective strategy for bladder management after total joint arthroplasty, reducing urinary retention and nursing time without increasing infection risk.

Area of Science:

  • Orthopedics
  • Urology
  • Health Economics

Background:

  • Postoperative urinary retention is a common complication after total joint arthroplasty.
  • Current bladder management strategies vary, impacting patient outcomes and healthcare costs.

Purpose of the Study:

  • To evaluate the impact of indwelling Foley catheters versus intermittent catheterization on bladder dysfunction and urinary tract infections (UTIs) after total joint arthroplasty.
  • To assess the cost-effectiveness of different bladder management approaches.

Main Methods:

  • Prospective randomized controlled trial comparing indwelling Foley catheter (group 1) versus intermittent catheterization (group 2) for 48 hours post-surgery.
  • Monitoring of UTI incidence, urinary retention, voiding volumes, and catheterization events.

Related Experiment Videos

  • Cost-effectiveness analysis including nursing time and hospital costs.

    • Main Results:

    • No significant difference in UTI incidence between groups (8% vs. 12%).
    • Significantly lower rates of postoperative urinary retention in the indwelling Foley catheter group (19% vs. 35%).
    • Indwelling Foley catheter use reduced nursing contact time by over 150 minutes per patient and saved $3,000 in total hospital costs.

    Conclusions:

    • Indwelling Foley catheters are a cost-effective method for managing bladder function post-total joint arthroplasty.
    • This approach effectively reduces urinary retention and is not associated with increased UTI risk.
    • Indwelling catheterization is less labor-intensive and facilitates the return of normal bladder function.