Abstract
Background: A common problem following total joint arthroplasty is urinary retention, which often necessitates catheterisation in the postoperative period. Most of these catheterisations are done as an emergency in the ward where the sterility is less than optimal.
Methods : A retrospective study of the incidence of emergency urinary catheterisation in 300 male patients who underwent total joint Arthroplasty under spinal anaesthesia over an eighteen-month period is presented. The patients were divided into three groups according to their age Group 1 (50 to 65 yrs), Group 2 (65 to 70 yrs) and Group 3 (70 + yrs).
Results: The incidence of catheterisation for acute urinary retention in Group 1 was 20%, Group 2 – 65% and Group 3 –69%.
Discussion: Urinary stasis predisposes to infection. The direct relationship between urinary catheterisation and infections in total joint Arthroplasty is already well documented. The potential for infection is compounded if the procedure is carried out in the unsterile ward environment. This study shows that the incidence of emergency catheterisation in patients aged 65 or above was high (average 67%) .
Conclusion: We conclude that these patients in groups 2 and 3 should be catheterised electively in the optimal sterile environment of the operating theatre. Catheterization should be performed after the patient has had the anaesthetic and the prophylactic intravenous antibiotic has been administered. The potential occurrence of joint and urinary tract infection is reduced and consequently patient morbidity is lessened.
The abstracts were prepared by Nico Verdonschot. Correspondence should be addressed to him at Orthopaedic Research Laboratory, University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
