Faculty Collaboration Database

Postoperative Urinary Retention After Bariatric Surgery: An Institutional Analysis. J Surg Res 2019 Nov;243:83-89

Date

06/07/2019

Pubmed ID

31170554

DOI

10.1016/j.jss.2019.05.005

Scopus ID

2-s2.0-85066406487 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

BACKGROUND: Postoperative urinary retention (POUR) can impact quality outcomes, leading to urinary tract infections, longer lengths of stay, and increased healthcare costs. The incidence of POUR in bariatric patients is unknown. Our primary objective was to determine the incidence and risk factors contributing to POUR in primary bariatric surgery.

METHODS: A retrospective review was conducted on patients who underwent a laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) from 2013 to 2017. POUR was defined as the inability to urinate postoperatively, requiring urinary catheterization. Univariate and multivariate analyses were performed on perioperative variables and their correlation with POUR.

RESULTS: During the study period, 603 patients underwent surgery: 317 (52.6%) LSG and 286 (47.4%) LRYGB. Overall, 49 (8.1%) patients developed POUR. There were no significant differences in preoperative demographics between patients with and without POUR. Patients who underwent an LSG had an increased incidence of POUR compared with LRYGB (P = 0.002). In both procedures, POUR was associated with decreased neostigmine, isolated nondepolarizing muscle relaxant, and reduced intraoperative fluid. LSG and congestive heart failure, as well as LSG and body weight, were independently associated with POUR. Female patients who experienced POUR had significantly increased length of stay.

CONCLUSIONS: Risk factors associated with POUR after primary bariatric surgery include LSG, less intraoperative neostigmine and intravenous fluids, and isolated nondepolarizing muscle relaxants. These risk factors can help educate patients and providers, as well as identify quality initiatives that focus on perioperative and anesthetic management to reduce POUR and length of hospital stay.

Author List

Roadman D, Helm M, Goldblatt MI, Kindel TL, Gould JC, Higgins RM

Authors

Matthew I. Goldblatt MD Professor in the Surgery department at Medical College of Wisconsin
Jon Gould MD Chief, Professor in the Surgery department at Medical College of Wisconsin
Rana Higgins MD Associate Professor in the Surgery department at Medical College of Wisconsin
Tammy Lyn Kindel MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Bariatric Surgery
Female
Humans
Incidence
Laparoscopy
Length of Stay
Logistic Models
Male
Middle Aged
Perioperative Care
Postoperative Complications
Retrospective Studies
Risk Factors
Urinary Retention