The Role of Intraoperative Urinary Catheters on Postoperative Urinary Retention after Total Joint Arthroplasty: A Multi-Hospital Retrospective Study on 9,580 Patients

Document Type : RESEARCH PAPER

Authors

1 Department of Orthopedics, South Bay Medical Center, Kaiser Permanente Southern California Medical Group, Harbor City, CA, USA- 2196 Gaston Street, Winston-Salem, NC, USA

2 Department of Urology, South Bay Medical Center, Kaiser Permanente Southern California Medical Group, Harbor City, CA, USA

3 Department of Orthopedics, San Diego Medical Center, Kaiser Permanente Southern California Medical Group, San Diego, CA, USA

4 Department of Orthopedics, South Bay Medical Center, Kaiser Permanente Southern California Medical Group, Harbor City, CA, USA

Abstract

Background: Urinary catheters (UC) are used by some surgeons during total joint arthroplasty (TJA). This study
investigated the impact of intraoperative urinary catheters on postoperative urinary retention (POUR) following TJA
cases.
Methods: We conducted a retrospective comparative study across 11 medical centers on 9,580 TJA patients. Visits
to urgent care or the emergency department within 7 and 30 postoperative days were reviewed. Medical records
over a 12-month period for all patients older than 18 years old were used to gather demographic and surgical
data as well as the incidence of urinary tract infection (UTI). Chi-squared tests (RStudio) were used to determine
statistical significance against P-Values (P) < 0.05.
Results: 13 (0.14%) patients returned within 7 days for POUR. POUR was more common in males [10 (0.3%) vs.
3 (0.1%) females, (P = 0.01)]. There was no difference in POUR when comparing total hip and knee arthroplasty
procedures [0.16% vs. 0.12%, (P = 0.60)]. Of all operations, 25% had intraoperative UC use. There was no difference
in POUR between the UC and no UC groups [0.21 vs. 0.11%, (P = 0.26)]. However, there was an increase in UTI
in UC vs. no UC use within 7 postoperative days [0.92 vs. 0.43%, (P = 0.005)] and 30 postoperative days [2.60 vs.
1.50 %, (P < 0.001)].
Conclusion: In our study, there was no difference in POUR rates between the intraoperative UC vs. no UC groups.
Therefore, the use of intraoperative UC may not decrease the rate of POUR following TJA procedures. Additionally,
UTI risk was higher in the UC group which may be attributable to other factors, especially when comparing female
vs. male patients.
Level of evidence: II

Keywords

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The Archives of Bone and Joint Surgery
Volume 9, Issue 5
September and October 2021
Pages 480-486

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History

  • Receive Date: 03 June 2020
  • Revise Date: 09 November 2020
  • Accept Date: 02 December 2020

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