Post-Op Urinary Retention Incidence – Common Factors in Spine Surgery Cases
Oakland University William Beaumont School of Medicine
INTRODUCTION Post-Operative Urinary Retention (POUR) is a surgical complication where a patient cannot empty his/her bladder following surgery. This emergent condition requires readmission to prevent adverse effects from bladder over distention. In spine surgery, the incidence can reach approximately 38%. This high rate of readmission has an adverse effect on patient outcome, satisfaction, and healthcare resources. The primary goal of this study is to find common factors between patients that develop urinary retention and to determine the statistical likelihood of developing urinary retention based on the presence of these common factors. METHODS The medical chart of 1,607 surgical spine patients was reviewed retrospectively to look for common factors. The patient population includes all patients who developed urinary retention from Dec 2014 to June 2016. The variables being collected from the medical chart review include: patient demographics (age, sex, BMI, length of stay), medical and surgical history (surgical procedure, length of surgery, number of previous surgeries, predisposing factors such as BPH, osteoporosis, and compression fractures), hospitalization details, and concomitant medications. RESULTS The POUR group was 5.45 years older (average age of 62.46), Length of Stay was increased by 2 days, foley catheter duration was 0.66 days longer, had a longer anesthesia time on average, and had a 2.7 times greater odds of being taken back to the OR. No statistical significance was found between men and women developing POUR. BPH and diabetes showed an 8 and 2.5 times greater odds of POUR, respectively. Previous cardiovascular procedure was associated with 2.2 times greater odds; no association was found with colorectal or urologic procedures. Antianginals and miscellaneous genitourinary products had a 3.9 and 14 times greater odds for POUR, respectively. CONCLUSION This study supports the hypothesis that there are measurable and identifiable common factors predisposing patient to POUR. Many of these factors including age, length of anesthesia, history of diabetes, BPH, previous cardiovascular procedure, and antianginal or genitourinary product use can be identified prior to or immediately after surgery. This data could be used to identify patient to monitor or prevent POUR before it occurs which would improve patient satisfaction and prevent complications, health risks, and costs associated with the pathology.