Postoperative Urinary Retention (POUR)
Conditions
Keywords
Postoperative urinary retention, Fast-track total hip (THA) and knee arthroplasty (TKA), Urinary bladder volume
Brief summary
Approximately 40 % of all patients undergoing fast-track total hip or knee arthroplasty needs intermittent bladder catheterization after surgery, as they are transient incapable of voluntary bladder emptying (postoperative urinary retention - POUR). The currently used interventional threshold for urinary bladder catheterization are a bladder volume of approximately 500 ml., but no evidence exists for this threshold. At the same time, the current knowledge suggest, that a bladder volume up to 1000 ml. for 2-4 hours are safe in humans, and as the use of urinary bladder catheterization are increasing the risk of complications, the investigators are hypothesizing that increasing the interventional threshold for urinary bladder catheterization after fast-track total hip or knee arthroplasty, will reduce the number of patients needing urinary bladder catheterization, without increasing the incidence of urological complications - including urinary tract infections.
Interventions
PROCEDUREincreased interventional threshold for urinary bladder catheterization (800 ml)
PROCEDURECurrent used interventional threshold for urinary bladder catheterization (500 ml)
DEVICEIntermittent bladder catheter
Sponsors
Lundbeck Foundation
Rigshospitalet, Denmark
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 125 Years
Healthy volunteers
No
Inclusion criteria
* planned for elective total hip or knee arthroplasty * given written informed consent for participation
Exclusion criteria
* can't co-operate to participation * can't speak or understand danish * preoperative use of urinary bladder catheterization * using haemodialysis * previous cystectomy * need for permanent urinary bladder catheter during surgery (decided by anaesthesiologist and/or surgeon) * Pregnant or given birth within the last 6 months
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Number of patients receiving postoperative urinary bladder catheterization | Patients will be followed from end of surgery to their first voluntary micturition, expectably within a mean period of twelve hours |
Secondary
| Measure | Time frame |
|---|---|
| Incidence of urinary tract infections | within the first 30 days after surgery |
| Number of voiding difficulties acquired postoperatively | within the first 30 days postoperatively |
| Number of readmissions due to urological issues (including urosepsis) | Within the first 30 days postoperatively |
Other
| Measure | Time frame |
|---|---|
| Time from last preoperative micturition to end of surgery. | Patients will be follwed from their last preoperative micturition to end of surgery. Expectably within a mean period of two hours. |
| Time from end of surgery to first postoperative, voluntary micturition. | Patient will be followed from end of surgery to their first postoperative, voluntary micturition. Expectably within a mean period of twelve hours. |
| Time from last preoperative micturitions to first postoperative bladder catheterization (if relevant). | Patients will be follwed from their last preoperative micturition to their first postoperative bladder catheterization (if relevant). Expectably within a mean period of six to eight hours. |
| Time from last preoperative micturition to first postoperative, voluntary micturition. | Patients will be follwed from their last preoperative micturition to their first postoperative, voluntary micturition. Expectably within a mean period of fourteen hours. |
| Time from end of surgery to first postoperative bladder catheterization (if relevant). | Patients will be follwed from end of surgery to their first postoperative bladder catheterization (if relevant). Expectably within a mean period of four to six hours. |
Countries
Denmark
Outcome results
None listed