Patient-related risk factors for urinary retention following ambulatory general surgery: a systematic review and meta-analysis

Am J Surg. 2016 Jun;211(6):1126-34. doi: 10.1016/j.amjsurg.2015.04.021. Epub 2015 Jul 17.

Abstract

Background: Postoperative urinary retention (POUR) is a source of avoidable patient harm. The aim of this review is to identify and quantify the role of patient-related risk factors in the development of POUR following ambulatory general surgery.

Methods: Studies published until December 2014 were identified by searching MEDLINE, EMBASE, and PsycINFO databases. Risk factors assessed in 3 or more studies were meta-analyzed.

Results: Twenty-one studies were suitable for inclusion consisting of 7,802 patients. The incidence of POUR was 14%. Increased age and the presence of lower urinary tract symptoms significantly increased risk with odds ratios [ORs] of 2.11 (95% confidence interval [CI] 1.15 to 3.86) and 2.83 (1.57 to 5.08), respectively. Male sex was not associated with developing POUR (OR .96, 95% CI .62 to 1.50). Preoperative α-blocker use significantly decreased the incidence of POUR with an OR of .37 (95% CI .15 to .91).

Conclusions: Increased age and the presence of lower urinary tract symptoms increase the risk of POUR, while α-blocker use confers protection. Male sex was not associated with POUR. These findings assist in preoperative identification of patients at high risk of POUR.

Keywords: Risk factors; Surgical treatment; Systematic review; Urinary retention.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Ambulatory Surgical Procedures / adverse effects*
  • Ambulatory Surgical Procedures / methods
  • Comorbidity
  • Female
  • General Surgery / methods
  • Humans
  • Incidence
  • Lower Urinary Tract Symptoms / epidemiology*
  • Male
  • Middle Aged
  • Postoperative Complications / diagnosis
  • Postoperative Complications / epidemiology*
  • Risk Assessment
  • Surgical Procedures, Operative / adverse effects*
  • Surgical Procedures, Operative / methods
  • Survival Analysis
  • Urinary Retention / diagnosis
  • Urinary Retention / epidemiology*