Postoperative urinary retention - prevalence and risk factors: prospective, cohort study

Abstract

Introduction. Ensuring perioperative urination maintenance can often be challenging, as postoperative urinary retention is frequently overlooked in favor of more clearly defined goals such as successful surgery, comprehensive postoperative pain control, reducing the risk of postoperative cardiorespiratory complications and shortening the patient’s overall hospital stay. However, the inability to initiate urination and empty the bladder in the early postoperative period may negatively affect each of the listed success criteria. Material and methods. A single-center, prospective, observational, cohort study was conducted, enrolling elderly patients without severe comorbidities. A total of 127 complete datasets were analyzed. Anthropometric parameters, type of surgery, duration of anesthesia and surgery; and several parameters previously reported as risk factors for postoperative urinary retention were recorded. The main objective wasto identify the prevalence of postoperative urinary retention in a surgical group in the Republic of Moldova. The secondary objective was to test the predictive value of a series of parameters (modifiable and non-modifiable) related to the patient or surgical treatment received as risk factors for urinary retention in the first 24 hours postoperatively. Statistical software used: Social Science Statistics (https://www.socscistatistics.com). Results. The studied surgical population was homogeneous in terms of body mass, height, duration of surgery and anesthesia; heterogeneous by gender (62.2% male) and type of anesthesia (64% general anesthesia). Depending on the definition criteria, the prevalence of postoperative urinary retention varied between 5.5% and 7.9%. The preoperative unmodifiable risk factors for postoperative urinary retention: positive history for hypertension OR = 9.0 (X2 (1, N = 127) = 5.6, p = 0.017), diabetes mellitus OR = 5.1 (X2 (1, N = 127) = 5.36, p = 0.021) and stroke OR = 4.83 (X2 (1, N = 127) = 2.098, p = 0.148). Conclusions. The prevalence of postoperative urinary retention in a single-center surgical population from the Republic of Moldova varies between 5.5% and 7.9%, depending on the criteria for postoperative urinary retention applied. This variation highlights the need for a consensus on diagnostic criteria for postoperative urinary retention is needed. Patients with hypertension and diabetes mellitus were more likely to develop postoperative urinary retention. Patients with pre-existing neurological disorders such as positive history for stroke and diabetic polyneuropathy were more susceptible for postoperative urinary retention.