INCIDENCE AND ASSOCIATED RISK FACTORS OF POSTOPERATIVE URINARY RETENTION AFTER SPINAL ANESTHESIA AT TERTIARY CARE HOSPITAL, PESHAWAR

Abstract

Postoperative urinary retention (POUR) is a common but often under-recognized complication following spinal anesthesia, particularly in lower limb and pelvic surgeries. This study aimed to determine the incidence of POUR and assess its association with spinal anesthetic drugs and other perioperative factors.

A descriptive cross-sectional study was conducted on 100 patients who underwent various surgical procedures under spinal anesthesia. Data were collected on patient demographics, medical history, type and duration of surgery, anesthetic agents used, and the occurrence, onset, symptoms, and management of POUR. Chi-square tests were used to assess the association between POUR and anesthetic drug type.

The overall incidence of POUR was 6%. All cases occurred in patients who received Bupivacaine (6 out of 96), while none occurred in the Lidocaine group (0 out of 4). However, the association between the type of spinal anesthetic drug and POUR was not statistically significant (p = 0.606). All POUR cases began more than 24 hours postoperatively and presented with decreased urine flow, painful urination, or incomplete voiding. Intermittent catheterization was used in all cases, and urinary retention persisted for more than 24 hours in each. No significant associations were found between POUR and patient age, gender or diabetes.

The incidence of POUR in patients receiving spinal anesthesia was low but clinically relevant. Although all cases occurred with Bupivacaine, no significant association was found between the anesthetic drug and POUR. Vigilant postoperative monitoring and timely management are recommended, and further studies with larger, balanced samples are needed to better understand contributing factors.