[Urination problems following total hip arthroplasty: insertion or not of an indwelling catheter?].
OBJECTIVE
To assess the frequency of urine retention and of urinary tract infection after total hip replacement in order to: to minimize morbidity due to urine retention and urinary tract infection after total hip replacement; to limit the discomfort to the patient; to decrease the work load of the nursing staff, if possible.


METHODS
University Hospital Rotterdam.


METHODS
Prospective, randomized.


METHODS
In 61 patients after 63 total hip replacements the use of an indwelling catheter for 48 hours (group 1) was compared with catheterisation on indication only (group 2).


RESULTS
Urine retention was less in group 1 than in group 2, 12/39 (31%) versus 15/24 (63%). In the subgroup males no difference was found between both groups. Urine retention was more frequent in elderly people. No other risk factors could be demonstrated. The number of patients with bacteriuria greater than 10(5) CFU/ml in group 1, 11/39 (28%) did not differ from group 2, 9/24 (38%).


CONCLUSIONS
On the basis of these study results we recommend: In females: to use an indwelling catheter for 48 hours after total hip replacement; In males: to discuss this choice with the patient, because use of an indwelling catheter appears not to decrease the frequency of urine retention. The risk of discomfort caused by catheterisation and urine retention still exists. An indwelling catheter can, without increasing the risk of significant bacteriuria, eliminate this discomfort in the first 48 hours after operation.
Lampe
H I
HI
Afd. Orthopedie, Academisch Ziekenhuis Rotterdam-Dijkzigt.
Sneller
Z W
ZW
Rijnberg
W J
WJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D014546:Urinary Catheterization; D016055:Urinary Retention / Q000517:prevention & control*; D014552:Urinary Tract Infections / Q000517:prevention & control*
Mictieproblemen na totale heupartroplastiek: wel of geen catheter à demeure?