High Post Voidal Residual Volume a risk for Postoperative Urinary Retention in Total Joint Arthroplasty

USA: Postoperative urinary retention (POUR) is a significant problem in total joint arthroplasty (TJA). Although risk factors for POUR have been well documented, they are ubiquitous in an aging total joint population, which makes risk stratification difficult. R.J. Magaldi et al. conducted a study to determine if a high preoperative post-void bladder scan identifies patients at risk for POUR.

Methods: A retrospective analysis was conducted on all TJAs performed at a high-volume orthopedic center between December 2019 and February 2020. A total of 585 elective TJA patients received postvoid bladder scans before surgery. Bladder scan volumes were correlated with catheterization via Chi square tests.

Results:

• A high post-void residual volume (PVRV > 50 ml) was associated with an increased risk of catheterization (23% vs 34%, chi-squared statistic = 6.2638, P value = .013), as was intravenous fluid volume (>1000 ml in knee, >2000 ml in hip).

• Catheterization rates were higher among total knee arthroplasty patients younger than 60 years (37% vs 24%, chi-squared statistic = 4.284, P value = .0385) and total hip arthroplasty (THA) patients older than 65 years (30% vs 18%, chi-squared statistic = 3.292, P value = .0695).