Fazeli Faramarz, Gooran Shahram, Taghvaei Majidreza Erfanian, Fazeli Kimia
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Glob J Health Sci. 2015 Mar 26;7(7 Spec No):93-6. doi: 10.5539/gjhs.v7n7p93.
Postoperative urinary retention-a common and important complication of surgical procedures, can occur after any form of surgical intervention, in both sexes and all ages regardless of patients' previous history of urinary problems. The importance of post operative urinary tract retention is due to its effect on development of post operative urinary infection, patient anxiety and discomfort, prolongation of hospital stay and increase in hospital costs and morbidity. The International Prostate Symptom Score (IPSS) is an easy method for quantifying and estimating the association between pre-operative bladder-outflow problems and post-operative urinary retention. The aim of present study was to investigate whether the IPSS could predict the likelihood of patients developing urinary retention after elective cataract surgery.
One hundred and fourteen male patients older than fifty years old, who were candidate for elective cataract surgery, were enrolled in this study. All patients completed an IPSS questionnaire form before operation, and classified into three groups regarding their score (0-7: mild, 8-19: moderate, 20- 35: severe).
Totally 8 patients (7%) developed post-operative urinary retention during first 24 hours after operation. Of the 8 urinary retention patients, 2 had moderate symptoms and 6had severe symptoms. There was a significant difference in developing postoperative urinary retention between patients having mild symptoms and patients having severe symptoms (P-value: 0.025).
It is concluded that while some litterateurs definitely support the idea that IPSS may be useful for predicting post operative urinary retention, there are still some controversies. Considering our results, it seems that IPSS score is not useful in the accurate prediction of those patients who are likely to develop postoperative retention after surgical procedures other than arthroplasty, and more precise studies are need to be conducted about urinary retention occurring postoperatively in different type surgeries, different methods of anesthesia considering age and gender of patients.
术后尿潴留是手术常见且重要的并发症,可发生于任何形式的手术干预后,无论男女及各年龄段,与患者既往泌尿系统问题病史无关。术后尿路潴留的重要性在于其对术后尿路感染的发生、患者焦虑与不适、住院时间延长、住院费用增加及发病率上升均有影响。国际前列腺症状评分(IPSS)是一种量化和评估术前膀胱流出道问题与术后尿潴留之间关联的简便方法。本研究旨在探讨IPSS是否能够预测择期白内障手术后患者发生尿潴留的可能性。
114例年龄超过50岁的择期白内障手术男性患者纳入本研究。所有患者在手术前均完成一份IPSS问卷表,并根据得分分为三组(0 - 7分:轻度,8 - 19分:中度,20 - 35分:重度)。
共有8例患者(7%)在术后首24小时内发生术后尿潴留。在这8例尿潴留患者中,2例症状为中度,6例症状为重度。轻度症状患者与重度症状患者在发生术后尿潴留方面存在显著差异(P值:0.025)。
虽然一些学者明确支持IPSS可能有助于预测术后尿潴留这一观点,但仍存在一些争议。鉴于我们的研究结果,似乎IPSS评分对于准确预测除关节置换术以外的其他手术患者术后可能发生尿潴留并无帮助,对于不同类型手术、考虑患者年龄和性别的不同麻醉方法术后发生的尿潴留,需要开展更精确的研究。