USE OF THE INTERNATIONAL PROSTATE SYMPTOM SCORE IN PREDICTING URINARY RETENTION AFTER TOTAL HIP REPLACEMENT

Abstract

Introduction: We assessed the correlation between the International Prostate Symptom Score (IPSS), patient age and incidence of post-operative catheterisation for retention in patients undergoing total hip replacement.

Methods And Results: 140 patients, 60 male and 80 female, admitted for total hip replacements between August 2005 and March 2006 were included. Pre-operatively patients were scored by the IPSS (0–35) according to the severity of their urinary symptoms. Patients were categorised into three symptom groups (mild, moderate and severe based on scores of 0–7, 8–18 and > 18 respectively) and four age groups (< 50, 51–60, 61–70 and > 70 years). All patients with post-operatively urinary retention were catheterised per urethra.

Results: 8 (13.3%) males and 7 (8.8%) females were catheterised post-operatively. The average IPSS value in non-catheterised males and females were 8.9 and 9.5 respectively whereas in catheterised males and females were 21 and 19 respectively. 75% of catheterised males had an IPSS > 18. 85.7 % of catheterised females had an IPSS > 18. Statistical analysis showed significant association between high IPSS (> 18) and catheterisation risk in both males (chi square - p< 0.001, sensitivity- 0.75, specificity- 0.92, negative predictive value (NPV) - 0.96) and females (chi square - p< 0.001, sensitivity- 0.86, specificity- 0.90, NPV- 0.99). There was no significant relation between age and incidence of catheterisation.

Discussion: IPSS is a widely accepted, simple and easy to use tool to predict patients at risk of post-op catheterisation. It is a simple pre-assessment tool even in female patients. Patients with IPSS > 18 are most at risk of post-op retention.