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

  • J. J. CroninEmail author
  • F. J. Shannon
  • E. Bale
  • W. Quinlan
Original Article


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.


Urinary retention Arthroplasty Catheter Symptom score 

Prédictions des rétentions urinaires post-opératoires après arthroplasties de hanche et de genou dans une population masculine


La rétention urinaire est une complication importante des arthroplasties de hanche et de genou. La mise en place d’une sonde urinaire est associée à une incidence augmentée d’infection de prothèse [2, 4]. Le but de ce travail est d’évaluer le taux des rétentions urinaires postopératoires et de rechercher si le score IPSS préopératoire peut être utilisé pour prédire la survenue d’une rétention postopératoire. 118 patients ont été inclus dans cette étude prospective. Parmi eux 28 devaient subir une arthroplastie du genou et 90 une arthroplastie de hanche. Les patients devaient remplir à l’admission le questionnaire IPSS. L’âge, le type d’anesthésie, les pertes sanguines peropératoires, la durée de l’intervention ont été notés. 45 patients (38.14%) ont présenté une rétention urinaire postopératoire, 31 après prothèse totale de hanche (34.4%) et 14 patients (50%) après prothèse totale de genou. Le score IPSS était en moyenne de 8.73 pour ceux qui ont présenté une rétention urinaire comparé à un score moyen de 4.315 pour les autres patients (P < 0.01). Le score IPSS est significativement plus élevé chez les patients qui devront être sondés. Ce score peut donc être utilise pour prédire l’apparition d’une rétention urinaire après prothèse totale de hanche ou de genou.

Mots clés

Rétention aiguë d’urine Arthroplastie Sondage Score 


  1. 1.
    Barry MJ, Fowler FJ Jr, O’Leary MP et al (1992) The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol 148(5):1549–1557 (discussion 1564)Google Scholar
  2. 2.
    David TS, Vrahas MS (2000) Perioperative lower urinary tract infections and deep sepsis in patients undergoing total joint arthroplasty. J Am Acad Orthop Surg 8(1):66–74PubMedGoogle Scholar
  3. 3.
    Elkhodair S, Parmar HV, Vanwaeyenbergh J (2005) The role of IPSS in predicting acute retention of urine in patients undergoing major joint arthroplasty. Surgeon 3(2):63–65PubMedCrossRefGoogle Scholar
  4. 4.
    Haase DA, Harding GKM (1984) The urethral catheter and infection. Compan Surg 1(4):1–6Google Scholar
  5. 5.
    Hozack WJ, Carpiniello V, Booth RE Jr (1998) The effect of early bladder catheterization on the incidence of urinary complications after total joint replacement. Clin Orthop 231:79–82Google Scholar
  6. 6.
    Knight RM, Pellegrini VD (1996) Bladder management after total joint arthroplasty. J Arthroplasty 11:882–888PubMedCrossRefGoogle Scholar
  7. 7.
    Michelson JD, Lotke PA, Steinberg ME (1988) Urinary bladder management after total joint replacement surgery. New Engl J Med 319:321–26PubMedCrossRefGoogle Scholar
  8. 8.
    Oishi CS, Williams VJ, Hanson PB, Schneider JE, Colwell CW, Walker RH (1995) Perioperative bladder management after primary total hip arthroplasty. J Arthroplasty 10:732–736PubMedCrossRefGoogle Scholar
  9. 9.
    Petersen MS, Collins DN, Selakovich WG, Finkbeiner AE (1991) Post-operative urinary retention associated with total hip and total knee arthroplasties. Clin Orthop 269:102–108PubMedGoogle Scholar
  10. 10.
    Waterhouse N, Beaumont AR, Murray K, Staniforth P, Stone MH (1987) Urinary retention after total hip replacement. A prospective study. J Bone Joint Surg Br 69(1):64–66PubMedGoogle Scholar
  11. 11.
    Wroblewski BM, del Sel HJ (1980) Urethral instrumentation and deep sepsis in total hip replacement. Clin Orthop 146:209–212PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • J. J. Cronin
    • 1
    • 2
    Email author
  • F. J. Shannon
    • 1
  • E. Bale
    • 1
  • W. Quinlan
    • 1
  1. 1.Cappagh National Orthopaedic HospitalDublin 11Ireland
  2. 2.Dublin 15Ireland

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