title: Perioperative bladder distension: a prospective study.
abstract: OBJECTIVE
  Postoperative urinary retention and bladder distension are frequent complications of surgery. The aim of this study was to determine the incidence of perioperative bladder distension in a surgical setting and to identify predisposing factors among patients undergoing common general and orthopaedic procedures.
  
  
  METHODS
  This was a prospective observational study of 147 adult patients admitted to orthopaedic and surgical departments. Bladder volumes were measured with an ultrasound scanner on three occasions: after emptying the bladder before being transported to the operating theatre, and then immediately before and after surgery.
  
  
  RESULTS
  Thirty-three patients (22%) developed bladder distension (>500 ml), eight preoperatively and 25 postoperatively. A total of 21 patients (14%) had a bladder volume >300 ml immediately before surgery. Orthopaedic patients were more likely to develop preoperative bladder distension than surgical patients and had significantly higher postvoid residual volumes. In the binary logistic regression analysis age, gender and time of anaesthesia could not predict bladder distension. Patients undergoing orthopaedic surgical procedures, however, were prone to bladder distension (odds ratio 6.87, 95% confidence interval 1.76 to 26.79, p=0.006).
  
  
  CONCLUSIONS
  This study shows that orthopaedic surgical patients are more prone to bladder distension perioperatively. The conventional method of encouraging patients to void at the ward before being transported to the operating theatre does not necessarily mean an empty bladder at the start of the operation.
authors.affiliation: Department of Clinical Science and Education, Karolinska Institutet, Sodersjukhuset, Stockholm, Sweden. eva.joelsson-alm@sodersjukhuset.se
authors.forename: Eva
authors.initials: E
authors.lastname: Joelsson-Alm
authors.forename: Claes R
authors.initials: CR
authors.lastname: Nyman
authors.forename: Christina
authors.initials: C
authors.lastname: Lindholm
authors.forename: Johanna
authors.initials: J
authors.lastname: Ulfvarson
authors.forename: Christer
authors.initials: C
authors.lastname: Svensen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014546:Urinary Catheterization; D016055:Urinary Retention / Q000453:epidemiology* / Q000517:prevention & control; D055815:Young Adult