[Postoperative urinary retention].
BACKGROUND
Retention of urine is a common postoperative problem.


METHODS
We present two patients with postoperative urinary retention. Current opinions on monitoring and treatment are reviewed.


RESULTS
One male postoperative patient was transferred from the postanaesthesia care unit after orthopaedic surgery under spinal anaesthesia. Shortly thereafter he collapsed. Hypotension and bradycardia were treated with intravenous ephedrine and atropine. Urinary retention was suspected and the bladder catheterised for 1,000 ml urine. A follow-up examination revealed no sequelae. A female patient was operated for haemorrhoids under epidural anaesthesia. The second postoperative day she was catheterised for 1,500 ml of urine. Two years later she had an ovarian cyst removed under general anaesthesia. Postoperative urinary retention developed with bladder overdistension (volume > 1,000 ml). A follow-up examination showed rest urine of 25 to 75 ml, and a chronic bladder dysfunction. The incidence of postoperative urinary retention varies depending upon type of surgery, gender, age, and preoperative history of urinary tract dysfunction. Method of anaesthesia or postoperative pain treatment is not correlated to incidence of urinary retention, but excessive intravenous volume load during the operation is.


CONCLUSIONS
Postoperative urinary retention should be monitored in all patients after surgery. All patients with history of difficulties with micturition need close supervision to avoid urinary bladder overdistention.
Rosseland
Leiv Arne
LA
Anestesiavdelingen Rikshospitalet 0027 Oslo. leiv.arne.rosseland@rikshospitalet.no
Stubhaug
Audun
A
Breivik
Harald
H
Medby
Per Christian
PC
Larsen
Helge Holst
HH
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy; D016055:Urinary Retention / Q000175:diagnosis / Q000209:etiology / Q000628:therapy