Faculty Collaboration Database

Indwelling Urinary Catheter for Total Joint Arthroplasty Using Epidural Anesthesia. J Arthroplasty 2019 Oct;34(10):2324-2328

Date

07/16/2019

Pubmed ID

31303377

DOI

10.1016/j.arth.2019.05.047

Scopus ID

2-s2.0-85068551386 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

BACKGROUND: The objective of this study was to evaluate if not placing an indwelling urinary catheter leads to a higher potential for adverse genitourinary (GU) issues after total joint arthroplasty (TJA) under epidural anesthesia.

METHODS: Three hundred thirty-five consecutive patients who underwent primary TJA using epidural anesthesia were retrospectively reviewed. The initial 103 patients received a preoperative urinary catheter, which was maintained until the morning of postoperative day 1. The subsequent 232 patients did not receive a preoperative urinary catheter. Demographics, medical complications, GU complications, and length of stay were compared between groups.

RESULTS: Compared between catheter and noncatheter groups, there were no differences in demographics including age, gender, or laterality of surgery. There was a difference in type of surgery (total knee arthroplasty vs total hip arthroplasty) (P = .008). There was no difference in American Society of Anesthesiologists score, but with a difference in body mass index (P = .01). There were no differences in GU complications among patients with benign prostatic hyperplasia or prostate cancer. However, among patients with a history of prostate disorders (benign prostatic hyperplasia or prostate cancer), urinary tract infection rate was higher in catheter group (P = .023). Postoperative GU complications were associated with increased median age in years and increased average length of stay in days.

CONCLUSION: Patients undergoing TJA under epidural anesthesia demonstrate no increased risk of postoperative urological complications without the placement of preoperative indwelling urinary catheter. The routine use of preoperative catheters can be reconsidered for this mode of anesthesia.

LEVEL OF EVIDENCE: Level II, retrospective comparative study.

Author List

Scotting OJ, North WT, Chen C, Charters MA

Author

Oliver Scotting MD Staff Physician in the Orthopaedic Surgery department at Medical College of Wisconsin

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

Aged
Anesthesia, Epidural
Arthroplasty, Replacement, Hip
Arthroplasty, Replacement, Knee
Catheters, Indwelling
Female
Humans
Male
Middle Aged
Postoperative Complications
Postoperative Period
Prospective Studies
Retrospective Studies
Risk
Urinary Catheterization
Urinary Catheters
Urinary Tract Infections