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J Orthop. 2015 Dec; 12(Suppl 2): S157–S160.

High rates of postoperative urinary retention following primary total hip replacement performed under combined general and spinal anaesthesia with intrathecal opiate

Michael David,a,⁎ Elizabeth Arthur,b Raveena Dhuck,b Ellie Hemmings,b and David Dunlopc
Hip

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.


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