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

Abstract

INTRODUCTIONThere 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 METHODSA 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.RESULTSOverall, 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.CONCLUSIONSWe 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.