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Joint Diseases and
Related Surgery
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Original Article · Open access

Incidence and clinical predictors of postoperative urinary retention following total hip and total knee arthroplasty: A single-center, prospective study

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Cheng En Tsai

Department of Orthopaedics, Chi Mei Medical Center, Tainan, Taiwan

ORCID: 0009-0004-2129-9416

Wen-hsin Tseng

Department of Surgery, Division of Urology, Chi Mei Medical Center, Tainan, Taiwan

ORCID: 0000-0003-3984-6751

Wen-shuo Chang

Department of Orthopaedics, Chi Mei Medical Center, Tainan, Taiwan

ORCID: 0000-0002-9934-6970

Chung-han Ho

Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan Department of Information Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan

ORCID: 0000-0001-5925-8477

Chi-sheng Chien

Department of Orthopaedics, Chi Mei Medical Center, Tainan, Taiwan

ORCID: 0000-0001-7880-3282

Abstract

Objectives: This study aims to evaluate the incidence and clinical predictors of postoperative urinary retention (POUR) following total joint arthroplasty (TJA) and to evaluate whether preoperative bladder voiding efficiency (BVE) can independently predict POUR.

Patients and methods: Between September 2023 and May 2024, a total of 200 patients (66 males, 134 females; median age: 69 years; range, 32 to 90 years) scheduled for primary total hip or knee arthroplasty were prospectively analyzed. Patients were classified into POUR (n=33) and non-POUR (n=167) groups. Demographic characteristics, urological history, operative variables, the International Prostate Symptom Scores (IPSS), and bladder scanner measurements were collected and compared.

Results: The overall incidence of POUR was 16.5% (33/200). Compared to the non-POUR group, the POUR group exhibited significantly higher IPSS (p<0.001) and lower BVE (p=0.0016). Higher body mass index (p<0.001), hypertension (p<0.001), and diabetes mellitus (p<0.001) were significantly associated with POUR development.

Conclusion: Higher preoperative IPSS and lower BVE seem to be independently associated with POUR following TJA. Notably, BVE emerges as a novel and clinically meaningful predictor. Routine preoperative assessment of BVE and IPSS may aid in the early identification of high-risk patients, enabling the implementation of targeted strategies to prevent POUR and its associated complications.

Declarations

Author Contributions

Contributed to the conception and design of this study, contributed to preparation and critical revision of the manuscript: C.E.T., C.S.C.; Data collection and/or processing: C.E.T., W.S.C., W.H.T.; Analysis and/or interpretation: C.E.T., C.H.H.; Literature review: C.E.T., W.S.C.; Materials and resources: C.E.T., W.S.C. The final version of the article was read and approved by all the authors.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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