This study investigates the overall rate of
urinary retention in a large cohort of unselected orthopaedic patients who had either general or
regional anesthesia and defines the risk factors for postoperative
urinary retention in that cohort of patients. A total of 15,681 patients who underwent major orthopaedic surgery with general or spinal/
epidural anesthesia were included. Postoperative
urinary retention was defined as any patient who required a postoperative consultation to the urologic department regarding voiding difficulty. Age at surgery, sex, type of surgery, medical history including
hypertension and
diabetes mellitus, and type of
anesthesia were analyzed as potential predictor variables. There were 365 postoperative patients who required urology consults for
urinary retention (2.3%). Older age at surgery (OR, 1.035; P < 0.0001), male sex (OR, 1.522; P = 0.0004), type of surgery (OR, 1.506; P = 0.0009), history of
hypertension (OR, 1.288; P = 0.0436), and history of
diabetes mellitus (OR, 2.038; P < 0.0001) were risk factors for
urinary retention after orthopaedic surgery. Advanced age, male sex,
joint replacement surgery, history of
hypertension, and
diabetes mellitus significantly increased the risk of
urinary retention. In patients with these risk factors, careful postoperative urological management should be performed.