Urinary Retention Frequent After Spinal Stenosis Surgery
Improper management of transient POUR leads to bladder overdistension and permanent bladder detrusor damage.
(HealthDay News) — Postoperative urinary retention (POUR) is a common morbidity after surgery for degenerative lumbar spinal stenosis, according to research published in the April issue of The Spine Journal.
Sungjoon Lee, MD, from the Inje University Haeundae Paik Hospital in South Korea, and colleagues reviewed the cases of 284 consecutive patients (male, 125; mean age, 63.3 years) who underwent spinal surgery for degenerative lumbar spinal stenosis. All patients were monitored for POUR using a systematic postoperative voiding care protocol.
The incidence of POUR was 27.1%. The researchers found that significant risk factors included older age (odds ratio, 1.062; 95% confidence interval, 1.029 to 1.095) and a long duration of surgery (odds ratio, 1.003; 95% confidence interval, 1.001 to 1.005). The probability of POUR was determined using a formula, and a probability of ≥0.26 was established as the cut-off value (sensitivity, 0.75; specificity, 0.57).
"We recommend adopting a systematic postoperative voiding care protocol to prevent bladder overdistension and detrusor damage, especially for elderly patients and those who have undergone longer surgeries," the authors write.
- Lee S, Kim CH, Chung CK, et al. Risk factor analysis for postoperative urinary retention after surgery for degenerative lumbar spinal stenosis. Spine J. 21 March 2017. doi: 10.1016/j.spinee.2016.03.017