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Risk and Management of Postoperative Urinary Retention Following Spinal Surgery

Authors
 Kwang Suk Lee  ;  Kyo Chul Koo  ;  Byung Ha Chung 
Citation
 International Neurourology Journal (대한배뇨장애요실금학회지), Vol.21(4) : 320-328, 2017 
Journal Title
 International Neurourology Journal (대한배뇨장애요실금학회지) 
ISSN
 2093-4777 
Issue Date
2017
Keywords
Postoperative Period ; Spinal Surgery ; Urinary Catheterization ; Urinary Retention
Abstract
PURPOSE: Postoperative urinary retention (POUR) is a common complication after spinal surgery. However, no clear definition of POUR currently exists, and no studies have evaluated the management of POUR. We aimed to investigate the prognostic factors for eventual POUR-free status in spinal surgery patients. METHODS: The records of patients who received a urologic consultation for POUR from January 2015 to December 2016 were reviewed. POUR-free status was defined as a voiding volume (VV) >100 mL and a VV ratio >50%. Patients with an indwelling Foley catheter and those with any postoperative complications were excluded. The patients were divided into 2 groups according to the primary management method (Foley catheterization [FC] or intermittent catheterization [IC]). RESULTS: In total, 205 patients (median age, 70.6 years) were evaluated. Significant prognostic factors for eventual POUR-free status were intraoperative FC, previous spinal surgery, operative level (L3-5), lumbar fusion, and total volume (TV) at the time of POUR. Bladder training and medication did not reduce the time to POUR-free status. In patients who underwent FC, the duration of indwelling FC was a significant prognostic factor for POUR-free status. In a subanalysis, the TV (≥500 mL) and VV ratio at the time of POUR were significant prognostic factors for POUR-free status after primary management. Among the patients who achieved a POUR-free status, 8 (6.4%) experienced recurrent POUR. The VV ratio (<62.0%) was the only predictor of recurrent POUR. CONCLUSIONS: The criterion of POUR-free status is useful after spinal surgery. IC and FC were similar in their efficacy for the management of these patients.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161632
DOI
10.5213/inj.1734994.497
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실)
Yonsei Authors
구교철(Koo, Kyo Chul)
이광석(Lee, Kwang Suk)
정병하(Chung, Byung Ha)
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