Urinary tract infection is a source of organisms responsible for deep infection of hip and knee joint prostheses. In an attempt to reduce the occurrence of post operative urinary sepsis, some orthopaedic surgeons insert indwelling urethral catheters (IDC) immediately prior to surgery with the aim of avoiding urine retention. The purpose of this study was to determine if preoperative indwelling urethral catheterisation reduces the incidence of urine retention following total hip and total knee arthroplasty.

124 patients who underwent total hip and total knee arthroplasty in New Plymouth between April 2001 and July 2002, were randomly allocated to either have an indwelling urethral catheter inserted preoperatively (IDC group), or no catheter (control group). Prior to surgery all patients completed a questionnaire enquiring about a history of urinary obstructive symptoms, or previous urinary tract infection. The two groups were compared with regard to demographic data, questionnaire findings and the amount of post operative opiate usage. The primary outcome measure for the study was post operative urine retention. Urinary tract infection post operatively was considered as a secondary outcome measure.

No difference was noted between the two groups with regard to age sex arthroplasty type, history of urinary obstruction, or previous urinary tract infection. Post operative urinary retention occurred in a significantly less number of patients in the IDC group compared with the control group. No difference in post operative urinary tract infection was noted between the groups with the sample size used in this study.

Our study suggests that the prophylactic use of indwelling urethral catheters prior to total hip and total knee arthroplasty is effective in reducing the occurrence of post operative urine retention.