Which of the following is MOST likely to be associated with an increased risk for postoperative urinary retention (POUR)?
- (A) Decreased intraoperative fluids
- (B) Male sex
- (C) Gynecologic surgery
POUR is a common postsurgical complication. Depending on multiple interacting factors, the incidence ranges from 5%-70% (Table). Interdependence between risk factors (e.g., lower limb arthroplasty and conduction anesthesia, or male sex and benign prostatic hypertrophy) results in the wide variation in the incidence and risk of POUR.
Table: Some of the factors reported to increase the risk of postoperative urinary retention (POUR).
Gynecologic surgery appears to be associated with a low risk for POUR, presumably because the bladder is routinely emptied during the surgical procedure. Excessive administration of intravenous fluids, rather than decreased intraoperative fluids, leads to overdistention of the bladder and impaired detrusor activity.