Introduction. Postvoid residualurine (PVR) can be an unknown chronic disorder, but it can also occur after surgery. A pilot-study initiated in Elective Surgery Center, Silkeborg led to collaboration with a urologist to develop a flowchart regarding treatment of PVR. Depending on the severity, men with significant PVR volumes were either recommend follow up by general practitioner or referred to an urologist for further diagnose and/or treatment. Aim: to determine the prevalence of pre- and postoperative PVR in men >65 years undergoing orthopedic surgeries and associated risk factors. Method. A single-center, prospective cohort study. Male patients were consecutively included during one year from April 2022. Data was extracted from the electronic patient files: age, lower urinary tract symptoms (LUTS), co-morbidity (e.g. diabetes), type of surgery and anesthesia, opioid use, pre- and postoperative PVR. Result. 796 participants; 316 knee-, 276 hip-, 26 shoulder arthroplasties and 178 lower back spinal surgeries. 95% (755) were bladder scanned preoperatively. 12% (89) had PVR 150-300ml, and 3% (23) had PVR >300ml. There was a higher risk of preoperative PVR ≥150ml in patients reporting LUTS, OR 1.97(1.28;3.03), having known neurological disease, OR 3.09(1.41;6.74), and the risk increased with higher age, OR 1.08 per year (1.04;1.12). Diabetes and the type of surgery was not associated with higher risk of PVR. 72% (569) had a postoperative bladder scan. 15% (95%CI: 12-19%) (70) patients without PVR preoperatively had PVR ≥150ml postoperatively. Conclusion. Approximately 15% of the men had PVR ≥150ml preoperatively. Neurological disease was the most severe risk factor and secondary if reporting LUTS. As expected, the risk increased with age. Neither diabetes nor the type of surgery was associated with higher risk. 15% of men without preoperative PVR had PVR after surgery. It is not possible to conclude if it is transient or chronic but further studies are ongoing

Introduction. Urinary catheterisation can cause bacteraemia and therefore may be associated with a risk of infection in hip and knee arthroplasty. However postoperative urinary retention can be distressing for the patient. This study investigates the factors that might predict the need for postoperative catheterisation in order to help develop a protocol to decide who should be electively catheterised. Methods. A prospective blinded study of 128 consecutive patients undergoing lower limb arthroplasty was carried out. No patient underwent perioperative catheterisation. Data obtained included sex, age, joint (hip or knee replacement), prostate score (IPSS), previous urinary retention, comorbidities and residual bladder volume after attempted complete voiding measured using an ultrasound bladder scanner. The type of anaesthesia and the requirement for urinary catheterisation postoperatively were recorded. Predictive risk factors were identified using binary logistic regression, and expressed as odds ratios (OR) and 95% confidence intervals (CI). Results. The mean age was 69.5 years (SD 8.9). There were 56 males and 72 females. 38 patients (30%) required postoperative catheterisation. Logistic regression identified the following predictive risk factors: bladder scan volume per ml increase (OR 1.006; CI 1.000–1.012); male sex (OR 5.51; CI 2.01–15.16); previous catheter (OR 4.26; CI 1.53–11.82); spinal/epidural/combined spinal epidural (CSE) anaesthesia (OR 6.78; CI 1.75–26.32); moderate IPSS score (OR 5.15; CI 1.73–15.37); severe IPSS score (OR 3.53; CI 0.605–20.54). The specificity of our model is 91%, the positive predictor value 71% and negative predictor value 82%. Discussion. Post-voiding bladder scan volume (1ml increase = 0.6% increased risk), male sex, history of retention, medium or high IPSS score and an epidural, spinal or CSE anaesthetic are independent risk factors that can be used preoperatively to predict the likelihood of postoperative retention

Urinary catheterisation may be associated with a risk of infection in hip and knee arthroplasty, however post-operative urinary retention can be distressing for the patient. This study investigates the factors that might predict the need for post-operative catheterisation. A prospective blinded study of 128 consecutive patients undergoing lower limb arthroplasty was carried out. Data obtained included sex, age, joint (hip or knee), prostate score (IPSS), previous urinary retention, co-morbidities and residual bladder volume after attempted complete voiding measured using an ultrasound bladder scanner. Anaesthetic type and requirement for urinary catheterisation postoperatively were recorded. Predictive risk factors were identified using binary logistic regression, and expressed as odds ratios (OR) and 95% confidence intervals (CI). The mean age was 69.5 years. There were 56 males and 72 females. 38 patients (30%) required post-operative catheterisation. Logistic regression identified the following predictive risk factors: bladder scan volume per ml increase (OR 1.006; CI 1.000–1.012); male sex (OR 5.51; CI 2.01–15.16); previous catheter (OR 4.26; CI 1.53–11.82); spinal/epidural/combined spinal epidural anaesthesia (OR 6.78; CI 1.75–26.32); moderate IPSS score (OR 5.15; CI 1.73–15.37); severe IPSS score (OR 3.53; CI 0.605–20.54). Our model specificity is 91%, positive predictor value 71% and negative predictor value 82%