IngentaConnect Can a urinary tract symptom score predict the development of post...

Authors: Sarasin, S.M.¹; Walton, M.J.¹; Singh, H.P.¹; Clark, D.I.¹

Source: Annals of The Royal College of Surgeons of England, Volume 88, Number 4, July 2006 , pp. 394-398(5)

Publisher: The Royal College of Surgeons of England

Abstract:

INTRODUCTION: There is no general consensus amongst orthopaedic surgeons on how best to manage the urinary tract and its complications after lower limb arthroplasty. This prospective audit investigates whether postoperative urinary retention can be predicted pre-operatively using the validated International Prostate Symptom Severity score (IPSS).

PATIENTS AND METHODS: A total of 182 patients undergoing lower limb arthroplasty under spinal anaesthetic were given the IPSS questionnaire to complete pre-operatively and an audit into numbers catheterised postoperatively was performed.

RESULTS: Overall, 69% of males and 39% of females required catheterisation. Following logistic regression analysis there was 0.85 predicted probability that males over 70 years would require catheterisation. The IPSS score was not useful in predicting retention in either sex at any age.

CONCLUSIONS: We propose that all males over 70 years undergoing this type of surgery should be catheterised pre-operatively and all other patients should be catheterised postoperatively with close monitoring of bladder volumes to prevent established urinary retention.

Keywords: ARTHROPLASTY; URINARY RETENTION; SPINAL ANAESTHESIA; AUDIT

Document Type: Research article

DOI: 10.1308/003588406X106531

Affiliations: 1: Department of Trauma and Orthopaedics, Derbyshire Royal Infirmary, Derby, UK

Can a urinary tract symptom score predict the development of postoperative urinary retention in patients undergoing lower limb arthroplasty under spinal anaesthesia? A prospective study