Lau Hung, Lam Becky
Department of Surgery, Tung Wah Hospital, University of Hong Kong Medical Centre, 12 Po Yan Street, Sheung Wan, Hong Kong.
ANZ J Surg. 2004 Aug;74(8):658-61. doi: 10.1111/j.1445-1433.2004.03116.x.
There has been no consensus on the best catheterization strategy for the management of postoperative urinary retention. A prospective randomized trial was undertaken to establish the best practice guidelines for the management of postoperative urinary retention. The authors also evaluated the contemporary incidence of urinary retention following different categories of general surgery and examined risk factors associated with its occurrence.
All patients who underwent elective inpatient surgery between January 2002 and June 2003 were recruited into the study. Patients who developed postoperative urinary retention were randomized to either having in-out catheterization or placement of an indwelling catheter for 24 h after surgery.
A total of 1448 patients was recruited. The overall incidence of urinary retention was 4.1% (n = 60). Significant risk factors associated with postoperative urinary retention included old age, anorectal procedures and use of spinal anaesthesia. Comparison of re-catheterization and urinary tract infection rates between patients who were treated with in-out versus overnight catheterization found no significant differences.
Postoperative urinary retention should be managed by in-out catheterization. Indwelling catheterization for 24 h appeared to bestow no additional benefits. The incidence of urinary retention increases with age, anorectal procedures and the use of spinal anaesthesia.
对于术后尿潴留的最佳导尿策略尚无共识。进行了一项前瞻性随机试验，以确立术后尿潴留管理的最佳实践指南。作者还评估了不同类别普通外科手术后尿潴留的当代发病率，并检查了与其发生相关的危险因素。
2002年1月至2003年6月期间接受择期住院手术的所有患者均被纳入研究。发生术后尿潴留的患者被随机分为术后进行一次进出式导尿或留置导尿管24小时。
共招募了1448名患者。尿潴留的总体发生率为4.1%（n = 60）。与术后尿潴留相关的显著危险因素包括老年、肛肠手术和使用脊髓麻醉。对接受一次进出式导尿与过夜留置导尿治疗的患者的再次导尿率和尿路感染率进行比较，未发现显著差异。
术后尿潴留应通过一次进出式导尿进行处理。留置导尿24小时似乎没有额外益处。尿潴留的发生率随着年龄、肛肠手术和脊髓麻醉的使用而增加。
