Preventing Urinary Retention After Lumbar Surgery
Who is likely to get urinary retention, and what should you do about it?
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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 . . .
