Login to Access Video or Poster Abstract: MP13-02
Sources of Funding: None

Introduction

Postoperative urinary retention (POUR) is a common complication across surgical specialties. To date, no literature has examined POUR as a predictor of long-term receipt of surgery for bladder outlet obstruction.

Methods

We performed a retrospective review of patients who underwent major inpatient, non-urologic surgery in California between 2008-2010. Patients were excluded for confounding urologic conditions (eg, bladder cancer, prostate cancer, prior bladder outlet procedures, etc). Patients were identified who developed POUR during their index admission, as were those who on a subsequent encounter underwent a bladder outlet procedure (BOP; transurethral resection of prostate, photoselective vaporization of prostate, suprapubic prostatectomy). Multivariate logistic regression was performed to identify predictors of subsequent bladder outlet procedure. Kaplan-Meier time-to-event analysis was performed to determine the cumulative incidence of subsequent BOP by patient groups (Group A: Age ≥ 60 years, POUR; Group B: Age ≥ 60 years, no POUR; Group C: Age < 60 years, POUR; Group D: Age < 60 years, no POUR).

Results

Of 769,141 eligible male patients, 8,051 (1.1%) developed POUR. Following discharge 1,855 patients (0.24%) underwent a BOP. BOP patients were significantly more likely to have experienced POUR during their index admission (6.3% vs 1.0%, p<0.001). Within 90 days, BOP was performed on 1.5% of Group A, compared to 0.2% of Group B (p<0.001). Within three years, rates of BOP were 7.0%, 2.1%, 0.8%, and 0.2% in Groups A-D, respectively (Figure). On multivariate analysis, the strongest predictors of subsequent BOP were age ≥ 60 years (OR 7.80, 95% CI 6.50-9.37) and POUR (OR 4.05, 95% CI 3.34-4.92).

Conclusions

In men aged ≥ 60 years, postoperative urinary retention identifies patients with an increased incidence of bladder outlet procedures within 3 months, as well as within three years. Men < 60 years have a low rate of subsequent bladder outlet procedure, regardless of postoperative urinary retention diagnosis.

Funding

None