Postoperative Urinary Retention in Modern Rapid Recovery Total Joint Arthroplasty

Daniel N. Bracey, Kawsu Barry, Harpal S. Khanuja, Vishal Hegde

Research output: Contribution to journalReview articlepeer-review


Postoperative urinary retention (POUR) is a disruptive complication after modern rapid recovery total joint arthroplasty. This review aims to synthesize the recent literature on POUR in the setting of total joint arthroplasty. The incidence of POUR ranges from 5.5% to 46.3%. The lack of a standardized definition of POUR accounts for some of this variability. Risk factors previously associated with the development of POUR include increasing age, male sex, benign prostatic hyperplasia, use of bupivacaine and intrathecal morphine in spinal anesthesia, glycopyrrolate, and volume of intraoperative intravenous fluid administered. Predictive scoring assessments, such as the International Prostate Symptom Score and a newer predictive nomogram, have not been adequately validated by high-quality studies. The treatment of POUR comprises either intermittent or indwelling urethral catheterization. Higher quality prospective studies are needed to allow for the standardization of all aspects of POUR from its diagnostic criteria to its treatment.

Original languageEnglish (US)
Pages (from-to)443-447
Number of pages5
JournalJournal of the American Academy of Orthopaedic Surgeons
Issue number10
StatePublished - May 15 2022

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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