1475. Analysis of Post-Operative Urinary Retention (POUR) Following Elective Spinal Surgery
Authors: Christian O. Bohan; Kim Rickert, MD; Thomas VanderMeer, MD (Sayre, PA)
Various aspects of spinal surgery such as manipulation of the spinal cord and nerve roots, patient positioning, and length of surgery can impact a patient’s ability to self-void after surgery. Risk factors associated with urinary retention include male sex, age, diabetes, and length of surgery. Urinary retention can lead to lengthened hospital stays, patient discomfort, and continued bladder dysfunction. The objective of this study was to identify patient and surgical factors associated with post-operative urinary retention.
A retrospective chart review of patients aged 18-85 who underwent elective spinal surgery from 12/2015 to 12/2017 at a single community medical center was conducted. Patients with complete urinary retention prior to surgery and those undergoing dialysis were excluded. Urinary retention was defined as: impaired bladder emptying with a post void residual > 350mL or inability to void within 6 hours of surgery with a volume of > 350mL in the bladder.
190 patients were included and 27.9% had urinary retention. No significant difference was noted between groups with and without urinary retention for a variety of factors such as level of surgery (cervical, thoracic, lumbar), type of procedure (decompression, fusion), sex, history of benign prostatic hyperplasia or diabetes. Body mass index (BMI) <30 showed a positive association with urinary retention compared to patients with a BMI 30+ (OR = 2.45, CI = 1.2-4.8). 46% of patients had a BMI 30+.
Urinary retention continues to be a common problem following spinal surgeries. This study identifies BMI <30 as a potential factor related to POUR. More research in this area is needed to determine proper perioperative management of these patients to limit adverse patient effects and maximize post-surgical outcomes. Specific areas for further study include anticholinergic medication use, patient age, body mass index, type of spinal procedure, and level of surgery.