Bracey Daniel N, Barry Kawsu, Khanuja Harpal S, Hegde Vishal
From the Department of Orthopaedic Surgery, University of North Carolina, Chapel Hill, NC (Bracey), and the Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD (Barry, Khanuja, and Hegde).
J Am Acad Orthop Surg. 2022 May 15;30(10):443-447. doi: 10.5435/JAAOS-D-21-00963. Epub 2022 Feb 24.
Postoperative urinary retention (POUR) is a disruptive complication after modern rapid recovery total joint arthroplasty. This review aims to synthesize the recent literature on POUR in the setting of total joint arthroplasty. The incidence of POUR ranges from 5.5% to 46.3%. The lack of a standardized definition of POUR accounts for some of this variability. Risk factors previously associated with the development of POUR include increasing age, male sex, benign prostatic hyperplasia, use of bupivacaine and intrathecal morphine in spinal anesthesia, glycopyrrolate, and volume of intraoperative intravenous fluid administered. Predictive scoring assessments, such as the International Prostate Symptom Score and a newer predictive nomogram, have not been adequately validated by high-quality studies. The treatment of POUR comprises either intermittent or indwelling urethral catheterization. Higher quality prospective studies are needed to allow for the standardization of all aspects of POUR from its diagnostic criteria to its treatment.
术后尿潴留（POUR）是现代快速康复全关节置换术后一种具有破坏性的并发症。本综述旨在综合全关节置换术中POUR的近期文献。POUR的发生率在5.5%至46.3%之间。POUR缺乏标准化定义是造成这种变异性的部分原因。先前与POUR发生相关的风险因素包括年龄增长、男性、良性前列腺增生、在脊髓麻醉中使用布比卡因和鞘内吗啡、格隆溴铵以及术中静脉输液量。预测性评分评估，如国际前列腺症状评分和一种新的预测列线图，尚未得到高质量研究的充分验证。POUR的治疗包括间歇性或留置导尿。需要更高质量的前瞻性研究，以便对POUR从诊断标准到治疗的各个方面进行标准化。
