Yoeri Bemelmans

Chapter 5 60 Abstract Purpose Postoperative urinary retention (POUR), defined as the inability to empty the bladder voluntary after surgery, is a commonly reported complication. This study reports the incidence and possible risk factors for POUR after elective fast-track hip or knee arthroplasty when using a nurse-led bladder scan protocol. Methods This retrospective cohort study includeddata from803patientswhounderwent unilateral hip or knee arthroplasty. Patients’ digital clinical records were reviewed for eligibility. Patients with incomplete data registration, preoperative bladder volume >250 ml, preexisting bladder catheterization, and/or patients following the outpatient pathway were excluded. Bladder volumes were assessed at different moments pre- and postoperatively. The outcomewas the incidence of POUR, defined as the inability to void spontaneously with a bladder volume >600ml, treated with indwelling catheterization. Further analysis between POUR and non-POUR patients was performed to detect possible risk factors for POUR. Results Six hundred and thirty-eight patients operated on primary unilateral hip or knee arthroplastywere analyzed. The incidence of POURwas 12.9%( n = 82, 95%CI 9.4–15.5). Gender, age, BMI, ASA classification, preoperative bladder volume, type of anesthesia, type of arthroplasty, and perioperative fluid administrationwere not significant different between POUR and non-POUR patients. Patients with a bladder volume of >200 ml at the recovery room were at higher risk (OR 5.049, 95% CI 2.815–9.054) for POUR. Conclusions When using a nurse-led bladder scan protocol in fast-track hip and knee arthroplasty, the incidence of POUR was 12.9%, with a bladder volume of >200ml at the recovery room as a risk factor for POUR. Keywords Postoperative urinary retention; POUR; Bladder scan; Hip arthroplasty; Knee arthroplasty