title: High rates of postoperative urinary retention following primary total hip replacement performed under combined general and spinal anaesthesia with intrathecal opiate.
abstract: BACKGROUND
  Postoperative urinary retention (POUR) occurs frequently following hip replacement.
  
  
  METHODS
  94 consecutive primary hip arthroplasty patients were assessed prospectively for POUR. 80 patients followed our anaesthesia protocol with combined general and spinal anaesthesia using bupivacaine and intrathecal diamorphine.
  
  
  RESULTS
  29 instances of POUR with higher rates in men and younger patients (under-50s), independent of either pre-existing renal impairment or opiate strength. POUR was observed to increase length of stay by 1.6 days.
  
  
  CONCLUSIONS
  We report a 36% overall rate of POUR. Males demonstrated a 3-fold increased risk. Patients should be counselled pre-operatively on the risk of urinary retention.
authors.affiliation: West Midlands Deanery, Trauma & Orthopaedic Training Programme, Birmingham B16 9RG, United Kingdom.
authors.forename: Michael
authors.initials: M
authors.lastname: David
authors.affiliation: West Midlands Deanery, GP Training Programme, South Birmingham B16 9RG, United Kingdom.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Arthur
authors.affiliation: West Midlands Deanery, GP Training Programme, South Birmingham B16 9RG, United Kingdom.
authors.forename: Raveena
authors.initials: R
authors.lastname: Dhuck
authors.affiliation: West Midlands Deanery, GP Training Programme, South Birmingham B16 9RG, United Kingdom.
authors.forename: Ellie
authors.initials: E
authors.lastname: Hemmings
authors.affiliation: The Royal Orthopaedic Hospital, Arthroplasty Hip & Knee, Birmingham B31 2AP, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Dunlop
keywords: Hip; Opiate; Replacement; Retention; Urinary