Can a urinary tract symptom score predict the development of postoperative urinary retention in patients undergoing lower limb arthroplasty under spinal anaesthesia? A prospective study.
BACKGROUND
There is no general consensus amongst orthopaedic surgeons on how best to manage the urinary tract and its complications after lower limb arthroplasty. This prospective audit investigates whether postoperative urinary retention can be predicted pre-operatively using the validated International Prostate Symptom Severity score (IPSS).


METHODS
A total of 182 patients undergoing lower limb arthroplasty under spinal anaesthetic were given the IPSS questionnaire to complete pre-operatively and an audit into numbers catheterised postoperatively was performed.


RESULTS
Overall, 69% of males and 39% of females required catheterisation. Following logistic regression analysis there was 0.85 predicted probability that males over 70 years would require catheterisation. The IPSS score was not useful in predicting retention in either sex at any age.


CONCLUSIONS
We propose that all males over 70 years undergoing this type of surgery should be catheterised pre-operatively and all other patients should be catheterised postoperatively with close monitoring of bladder volumes to prevent established urinary retention.
Sarasin
S M
SM
Department of Trauma and Orthopaedics, Derbyshire Royal Infirmary, Derby, UK. sarasinmarco@hotmail.com
Walton
M J
MJ
Singh
H P
HP
Clark
D I
DI
D000368:Aged; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D001178:Arthroplasty / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007866:Leg; D008297:Male; D008485:Medical Audit; D011183:Postoperative Complications / Q000175:diagnosis*; D011446:Prospective Studies; D011788:Quality of Life; D012044:Regression Analysis; D012720:Severity of Illness Index; D016055:Urinary Retention / Q000175:diagnosis*