Background

Ilizarov hip reconstruction is a salvage option traditionally done with fixators, which often face limited compliance. We aimed at reviewing our early results of a novel technique with internal devices.

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.

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.