Gönüllü N N, Gönüllü M, Utkan N Z, Dülger M, Gökgöz S, Karsli B
Department of General Surgery, Medical School of The Cumhuriyet University, Sivas, Turkey.
Eur J Surg. 1993 Mar;159(3):145-7.
To find out the incidence of retention of urine after various general surgical operations, and to assess the effects of applying a bag filled with warm water (40-45 degrees C), and encouraging early mobilisation onreducing the necessity for catheterisation.
Open study.
Cumhuriyet University Hospital, Sivas, Turkey.
577 consecutive patients who had no history of urinary problems and had not already been catheterised, and who underwent general surgical operations between April 1989 and December 1991.
Ability to pass urine spontaneously.
64 of 272 men (24%) and 47 of 305 women (15%) developed retention of urine (p = 0.02), and 15 and 11, respectively, required catheterisation. Patients were most likely to develop retention after repair of incisional hernia (13/32, 38%), midline laparotomy (19/82, 23%), and subcostal incisions (30/142, 21%), but there were no significant differences among these. Significantly more patients whose operations had lasted 60 minutes or more, and who had opiate analgesia, required catheterisation (5/232 compared with 21/345, p = 0.04, and 11/120 compared with 15 out of 457, p = 0.01, respectively). 85 of the 111 patients who went into retention (77%) were able to pass urine spontaneously after application of a bag containing warm water to the suprapubic region, and walking about. The mean period of catheterisation was 12 hours (range 4-76), and all patients but one passed urine spontaneously when the catheter was removed. Only two of the 26 patients who were catheterised developed microbiologically confirmed urinary tract infections.
Retention of urine is a common complication after general surgical operations, but the necessity for catheterisation can be kept to a minimum by simple and inexpensive measures.
了解各类普通外科手术后尿潴留的发生率，并评估应用装有温水（40 - 45摄氏度）的袋子以及鼓励早期活动对减少导尿必要性的效果。
开放性研究。
土耳其锡瓦斯的居米什耶特大学医院。
577例连续患者，他们无泌尿系统疾病史且未预先导尿，于1989年4月至1991年12月期间接受普通外科手术。
自主排尿能力。
272名男性中有64名（24%）发生尿潴留，305名女性中有47名（15%）发生尿潴留（p = 0.02），分别有15名男性和11名女性需要导尿。患者在切口疝修补术后（13/32，38%）、中线剖腹术后（19/82，23%）和肋下切口术后（30/142，21%）最易发生尿潴留，但这些情况之间无显著差异。手术持续60分钟及以上且使用阿片类镇痛药的患者中，需要导尿的比例显著更高（分别为5/232对比21/345，p = 0.04；11/120对比457名中的15名，p = 0.01）。111例发生尿潴留的患者中，85例（77%）在耻骨上区应用装有温水的袋子并走动后能够自主排尿。导尿的平均时长为12小时（范围4 - 76小时），除1例患者外，所有患者在拔除导尿管后均能自主排尿。26例接受导尿的患者中只有2例发生了经微生物学证实的泌尿系统感染。
尿潴留是普通外科手术后的常见并发症，但通过简单且廉价的措施可将导尿的必要性降至最低。
