The Role of Intraoperative Urinary Catheters on Postoperative Urinary Retention after Total Joint Arthroplasty: A Multi-Hospital Retrospective Study on ۹,۵۸۰ Patients

Background: Urinary catheters (UC) are used by some surgeons during total joint arthroplasty (TJA). This studyinvestigated the impact of intraoperative urinary catheters on postoperative urinary retention (POUR) following TJAcases.Methods: We conducted a retrospective comparative study across ۱۱ medical centers on ۹,۵۸۰ TJA patients. Visitsto urgent care or the emergency department within ۷ and ۳۰ postoperative days were reviewed. Medical recordsover a ۱۲-month period for all patients older than ۱۸ years old were used to gather demographic and surgicaldata as well as the incidence of urinary tract infection (UTI). Chi-squared tests (RStudio) were used to determinestatistical significance against P-Values (P) < ۰.۰۵.Results: ۱۳ (۰.۱۴%) patients returned within ۷ days for POUR. POUR was more common in males [۱۰ (۰.۳%) vs.۳ (۰.۱%) females, (P = ۰.۰۱)]. There was no difference in POUR when comparing total hip and knee arthroplastyprocedures [۰.۱۶% vs. ۰.۱۲%, (P = ۰.۶۰)]. Of all operations, ۲۵% had intraoperative UC use. There was no differencein POUR between the UC and no UC groups [۰.۲۱ vs. ۰.۱۱%, (P = ۰.۲۶)]. However, there was an increase in UTIin UC vs. no UC use within ۷ postoperative days [۰.۹۲ vs. ۰.۴۳%, (P = ۰.۰۰۵)] and ۳۰ postoperative days [۲.۶۰ vs.۱.۵۰ %, (P < ۰.۰۰۱)].Conclusion: In our study, there was no difference in POUR rates between the intraoperative UC vs. no UC groups.Therefore, the use of intraoperative UC may not decrease the rate of POUR following TJA procedures. Additionally,UTI risk was higher in the UC group which may be attributable to other factors, especially when comparing femalevs. male patients.Level of evidence: II

Keywords:

indwelling urinary catheter , postoperative urinary retention , perioperative management , total joint surgery , Urinary tract infection