VALIDITY OF INTERNATIONAL PROSTATE SYMPTOMS SCORING IN PREDICTING URINARY RETENTION AFTER JOINT REPLACEMENTS

Abstract

Aim: To assess the validity of International Prostate Symptom Score (IPSS) and incidence of catheterisation in patients undergoing joint replacements.

Methods and results: We assessed 302 patients admitted for total hip or total knee replacements (THR or TKR) between October 2005 and March 2006. Pre-operatively, patients were scored by the IPSS (0–35) for 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 years, 51–60 years, 61–70 years and > 70 years). All patients with post-op urinary retention were catheterised per urethra.

Results: There were 172 female (THR-91, TKR-81) and 130 male patients (THR-60, TKR-70). The average IPSS for males and females in non-catheterised patients were 10 and 9.7 respectively whereas in catheterised patients were 21.8 and 20 respectively.16 males and 10 females were catheterised post-operatively. 87.5% of catheter-ised males had IPSS > 18 and 75% were over 70 with IPSS > 18. Ninety percent of catheterised females had IPSS > 18 and 50% were over 70 with IPSS > 18. There was statistically significant association between high IPSS (> 18) and catheterisation risk in both males and females (Chi square test- p > 0.001 and p> 0.005 respectively) and between males over 70 years of age and cath-eterisation risk (p> 0.001).

Conclusion: 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 and males > 70 years are most at risk of post-op retention.