Sarasin S M, Walton M J, Singh H P, Clark D I
Department of Trauma and Orthopaedics, Derbyshire Royal Infirmary, Derby, UK.
Ann R Coll Surg Engl. 2006 Jul;88(4):394-8. doi: 10.1308/003588406X106531.
There is no general consensus amongst orthopaedic surgeons on how best to manage the urinary tract and its complications after lower limb arthroplasty. This prospective audit investigates whether postoperative urinary retention can be predicted pre-operatively using the validated International Prostate Symptom Severity score (IPSS).
A total of 182 patients undergoing lower limb arthroplasty under spinal anaesthetic were given the IPSS questionnaire to complete pre-operatively and an audit into numbers catheterised postoperatively was performed.
Overall, 69% of males and 39% of females required catheterisation. Following logistic regression analysis there was 0.85 predicted probability that males over 70 years would require catheterisation. The IPSS score was not useful in predicting retention in either sex at any age.
We propose that all males over 70 years undergoing this type of surgery should be catheterised pre-operatively and all other patients should be catheterised postoperatively with close monitoring of bladder volumes to prevent established urinary retention.
在下肢关节置换术后如何最佳地处理尿路及其并发症的问题上，骨科医生尚未达成普遍共识。这项前瞻性审计调查了能否使用经过验证的国际前列腺症状严重程度评分（IPSS）在术前预测术后尿潴留。
总共182例在脊髓麻醉下接受下肢关节置换术的患者在术前填写了IPSS问卷，并对术后导尿的人数进行了审计。
总体而言，69%的男性和39%的女性需要导尿。经过逻辑回归分析，70岁以上男性需要导尿的预测概率为0.85。IPSS评分在任何年龄都无法有效预测两性的尿潴留情况。
我们建议，所有70岁以上接受此类手术的男性应在术前导尿，所有其他患者应在术后导尿，并密切监测膀胱容量以预防已形成的尿潴留。
