Urinary retention after non-urological surgeries: management patterns and predictors of prognosis

Abstract

Objective: urinary retention after non-urological surgery is a common morbidity, yet its etiology and treatment approaches are still a matter of debate. The primary aims of this study are to evaluate the management of urinary retention after non-urological surgeries, determine the predictors of prognosis, and report follow-up data. Methods: patients who were referred to the urology clinic at a single center due to postoperative urinary retention between December 2014 and November 2021 were included. Demographical, clinical, and surgical parameters were recorded. In all patients, a urethral catheter was kept in-situ for at least 5 days after urinary retention. In case of persistent urinary retention after catheter removal, clean intermittent catheterization (CIC) was recommended. Results of the patients who spontaneously regained micturition after conservative treatment and those with persistent urinary retention were compared. Results: among 95 patients, the median age was 65 (24–90) years. In 75 patients (78.9%), spontaneous micturition returned with conservative management (Group 1). Twenty patients (21.1%) required CIC due to persistent urinary retention (Group 2). The percentages of males in Group 1 and 2 were 81.3% and 50% respectively (p<0.05). The ratio of non-supine positioning in Group 1 and Group 2 were, 10.6% (8/75) and 35% (7/20), respectively (p=0.02). Female gender and non-supine operative position remained significant predictors of persistent urinary retention after conservative treatment with odds ratios of 3.5 and 3.6, respectively (Confidence intervals, 1.2–10 and 1–12.1, p= 0.02 and 0.04, respectively). During a median follow-up duration of 36 (2–86) months, only 5 patients (20%) stopped doing CIC and voided spontaneously. The median CIC duration of these 5 patients was 6 (1–9) months. Conclusion: the majority of the patients who developed urinary retention after non-urological surgeries regained spontaneous micturition with conservative management. Female gender and non-supine operative positioning were independent risk factors for persistent urinary retention. In patients with persistent urinary retention, spontaneous micturition could be expected to return in approximately 6 months.