title: Treatment of urinary complications after total joint replacement in elderly females.
abstract: Urinary retention and the possible consequence of infection after total joint replacement is an important subject to urologists and orthopedic surgeons. A prospective, randomized study was performed in 77 elderly female patients with total joint replacement to test whether twenty-four-hour catheterization perioperatively or straight catheterization postoperatively in the recovery room might reduce the control group's incidence of postoperative urinary tract infection (9%), urinary retention (57%), and subsequent urinary catheterizations. In 16 percent of the patients who had straight catheterization in the recovery room a urinary tract infection developed postoperatively, and 65 percent of these patients required at least one more catheterization with 13 percent requiring a subsequent indwelling Foley catheter. The patients who had perioperative (immediately preoperatively and for 24 hours postoperatively) catheter drainage had a zero incidence of retention and only a 4 percent incidence of urinary tract infection. We recommend this regimen for elderly female patients undergoing total joint replacement under spinal anesthesia.
authors.affiliation: Urologic Center, Pennsylvania Hospital, Philadelphia.
authors.forename: V L
authors.initials: VL
authors.lastname: Carpiniello
authors.forename: M
authors.initials: M
authors.lastname: Cendron
authors.forename: H G
authors.initials: HG
authors.lastname: Altman
authors.forename: T R
authors.initials: TR
authors.lastname: Malloy
authors.forename: R
authors.initials: R
authors.lastname: Booth
mesh_terms: D000368:Aged; D001437:Bacteriuria / Q000517:prevention & control; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D007430:Intraoperative Care; D007720:Knee Prosthesis; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D011897:Random Allocation; D013997:Time Factors; D014546:Urinary Catheterization; D014552:Urinary Tract Infections / Q000517:prevention & control*; D014555:Urination Disorders / Q000517:prevention & control*