title: Patient-related risk factors for urinary retention following ambulatory general surgery: a systematic review and meta-analysis.
abstract: BACKGROUND
  Postoperative urinary retention (POUR) is a source of avoidable patient harm. The aim of this review is to identify and quantify the role of patient-related risk factors in the development of POUR following ambulatory general surgery.
  
  
  METHODS
  Studies published until December 2014 were identified by searching MEDLINE, EMBASE, and PsycINFO databases. Risk factors assessed in 3 or more studies were meta-analyzed.
  
  
  RESULTS
  Twenty-one studies were suitable for inclusion consisting of 7,802 patients. The incidence of POUR was 14%. Increased age and the presence of lower urinary tract symptoms significantly increased risk with odds ratios [ORs] of 2.11 (95% confidence interval [CI] 1.15 to 3.86) and 2.83 (1.57 to 5.08), respectively. Male sex was not associated with developing POUR (OR .96, 95% CI .62 to 1.50). Preoperative α-blocker use significantly decreased the incidence of POUR with an OR of .37 (95% CI .15 to .91).
  
  
  CONCLUSIONS
  Increased age and the presence of lower urinary tract symptoms increase the risk of POUR, while α-blocker use confers protection. Male sex was not associated with POUR. These findings assist in preoperative identification of patients at high risk of POUR.
authors.affiliation: Academic Surgical Unit, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK. Electronic address: sam.mason06@imperial.ac.uk.
authors.forename: Sam E
authors.initials: SE
authors.lastname: Mason
authors.affiliation: Academic Surgical Unit, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK.
authors.forename: Alasdair J
authors.initials: AJ
authors.lastname: Scott
authors.affiliation: Academic Surgical Unit, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK.
authors.forename: Erik
authors.initials: E
authors.lastname: Mayer
authors.affiliation: Academic Surgical Unit, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Purkayastha
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D015897:Comorbidity; D005260:Female; D013502:General Surgery / Q000379:methods; D006801:Humans; D015994:Incidence; D059411:Lower Urinary Tract Symptoms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D018570:Risk Assessment; D013514:Surgical Procedures, Operative / Q000009:adverse effects* / Q000379:methods; D016019:Survival Analysis; D016055:Urinary Retention / Q000175:diagnosis / Q000453:epidemiology*
keywords: Risk factors; Surgical treatment; Systematic review; Urinary retention