Study design:

The study is designed as a retrospective cohort study.

Objective:

To identify modifiable and non-modifiable risk factors of post-operative urinary retention in spine surgery patients.

Summary of background data:

post-operative urinary retention is a common complication in patients undergoing operative procedures requiring anesthesia. Current studies have shown significant risk factors for post-operative urinary retention, but most are non-modifiable and subsequently of limited usefulness in preventing this complication. Several new studies have shown possible modifiable risk factors, but current data is inconsistent in terms of their statistical significance.

Methods:

814 consecutive patients who underwent open posterior lumbar laminectomy and fusion were included in the retrospective cohort study. Pre, intra and post-operative characteristics were collected in all patients to identify risk factors for post-operative urinary retention.

Results:

Glycopyrrolate use (odds ration [OR] 2.60; p = 0.001), decreased body mass index (OR 0.96; p = 0.018), prior diagnosis of benign prostate hyperplasia (OR 3.34; p = <0.001), and post-operative urinary tract infection (OR 5.60 p = 0.005) were associated with post-operative urinary retention. Prior history of lumbar spine surgery (OR 0.55; p = 0.019) was associated with decreased rates of post-operative urinary retention.

Conclusion:

Glycopyrrolate use, benign prostate hyperplasia, and post-operative urinary tract infection were independent risk factors for post-operative urinary retention. The use of glycopyrrolate is a potentially modifiable risk factor for post-operative urinary retention.

Level of evidence:

3.