1600. Incidence and Risk Factors for Postoperative Urinary Retention After Minimally Invasive Transforaminal Lumbar Interbody Fusion
Authors: Ketan Yerneni; John Burke, MD, PhD; Richard Fessler, MD, PhD; Vincent Traynelis, MD; John O'Toole, MD, MS; Ricardo Fontes, MD, PhD; Lee Tan, MD; Harel Deutsch, MD (San Ramon, CA)
Postoperative urinary retention (POUR) is a common occurrence after interventional procedures. However, the risk factors contributing to POUR in relation to spinal surgery have been poorly resolved. Here, or goal was to identify risk factors that may contribute to POUR development following minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).
We retrospectively reviewed a prospectively maintained database of patients that underwent single or double-level MIS-TLIF between 2014-2015. The patient demographics and perioperative medications between patients with and without POUR were compared. Potential risk factors for POUR development were analyzed using logistic regression and multivariate analysis.
Of the 102 patients who underwent MIS-TLIF, 40.19% experienced POUR (n = 41). There was a significant association between male sex and the development of POUR (OR = 3.31, p = 0.04). Interestingly, there was a significant inverse association between BMI (OR = 0.89, p = 0.01), ethanol consumption (OR = 0.27, p = 0.03) and POUR incidence. Furthermore, an increased time taken for foley removal was significantly associated with a decreased POUR incidence (OR = 0.95, p = 0.04).
Nearly 40% of patients may develop POUR following MIS-TLIF. Patient demographics and lifestyle were the main factors associated with altered POUR incidence, while perioperative medications were not significantly involved. Male sex was the major risk factor associated with POUR development postoperatively. These findings suggest that hospital-related perioperative factors may not play a major role in the development of POUR in patients undergoing lumbar spine surgery. Future prospective, multi-center controlled studies will be needed to fully understand risk factors for POUR, leading to improved patient care, satisfaction, and decreased healthcare costs.