Prediction of post-operative urinary retention in hip and knee arthroplasty in a male population

Urinary retention is an important complication of hip and knee arthroplasty. The insertion of a urinary catheter has been associated with an increased incidence of implant infection in previous studies (David and Vrahas in J Am Acad Orthop Surg 8(1):66–74, 2000; Haase and Harding in Compan Surg 1(4):1–6, 1984). The purpose of this study was to assess the rates of urinary retention post-arthroplasty in our unit and to investigate if the patient’s pre-operative International Prostate Symptom Score (IPSS) could be used to predict the development of post-operative urinary retention. Patients numbering 118 were enrolled prospectively for this study. Twenty-eight were attending for knee arthroplasty with 90 attending for hip arthroplasty. The patients were asked to fill out an IPSS questionnaire form on admission. The patient’s age, mode of anaesthetic, intraoperative blood loss and operative time were recorded. Forty-five patients (38.14%) developed urinary retention post-operatively. Thirty-one patients (34.4%) following total hip replacement, and 14 patients (50%) following total knee replacement developed urinary retention. The mean pre-operative IPSS score was 8.73 for those who went into retention, compared to 4.315 for the other patients (P < 0.01). The mean IPSS score was significantly higher in patients requiring catheterization. These results show that this scoring system could be used to predict the development of post-operative urinary retention in patients presenting for hip or knee arthroplasty.