Preventing Urinary Retention After Lumbar Surgery

Who is likely to get urinary retention, and what should you do about it?

Preventing Urinary Retention After Lumbar Surgery
Smart Practice: If you’re thinking about outpatient lumbar spinal surgery, consider using a quick screening questionnaire to see whether the patient is likely to develop urinary retention.

What’s the Claim?

A meta-analysis of ten studies identified the following factors to be associated with urinary retention after lumbar spine surgery:

  • male sex (odds ratio of 1.4 compared to women)
  • older age
  • instrumented fusion (possibly related to longer surgical times and higher intraoperative fluid volume administration)
  • diabetes mellitus (OR of 1.5 compared to patients without diabetes)
  • coronary artery disease (OR of 1.9)
  • benign prostatic hypertrophy (the biggie, with an OR of 2.5)

Urinary retention after surgery was also associated with a higher risk of developing UTI, though it was impossible to say whether this was a cause or an effect.

How’s It Stack Up?

This was generally confirmatory of other meta-analyses, the best recent one having been done about three years ago in The Spine Journal. So let’s talk instead about what to do about it . . .