There is no general consensus amongst Orthopaedic Surgeons on how best to manage the urinary tract and its complications after lower limb arthroplasty. This prospective audit investigates whether post-operative urinary retention can be predicted pre-operatively using the validated International Prostate Symptom severity score (IPSS).

182 patients undergoing lower limb arthroplasty under spinal anaesthetic were given the IPSS questionnaire to complete pre-operatively and an audit into numbers catheterised post-operatively carried out.

69% of males and 39% of females required catheterisation. Following logistic regression analysis there was 0.85 predicted probability that males over seventy years would require catheterisation. The IPSS score was not useful in predicting retention in either sex at any age.

We propose that all males over seventy years undergoing this type of surgery should be catheterised pre-operatively and all other patients should be catheterised post-operatively with close monitoring of bladder volumes to prevent established urinary retention.