Risk factors for postoperative urinary retention among women who underwent laparoscopic cholecystectomy

Abstract

Objectives: The aim of this study was to investigate the risk factors for postoperative urinary retention (POUR) among female patients by evaluating its occurrence in women who underwent laparoscopic cholecystectomy in Gyeongsang National University Hospital.

Methods: The medical records of female patients who had undergone laparoscopic cholecystectomy for gallbladder stones between March 2014 and February 2018 were reviewed. Information was collected regarding patient age, body mass index (BMI), creatinine, absolute neutrophil count, duration of the operation and anesthesia, the amount of fluid infused, American Society of Anesthesiologists (ASA) classification, and medical comorbidities, such as hypertension, diabetes, and lung, liver, heart, renal, and neurologic disease. Comparisons were made between the POUR and non-POUR groups, and both univariate and multivariate analyses were conducted.

Results: Seventeen of 591 patients (2.9%) developed POUR. There as a positive correlation between age and POUR (P = 0.040), and a negative correlation between BMI and POUR (P = 0.037). In addition, a history of neurologic disease was greater in the POUR group (P = 0.033), which also had a higher ASA class than the non-POUR group (P < 0.001). Multivariate analysis showed that a high ASA class was a risk factor for POUR (hazard ratio 3.01; 95% confidence interval 1.13-7.99; P = 0.027).

Conclusions: Medical care providers need to be aware of the risk factors for POUR, which is likely to prolong hospital stay for Foley catheter placement. A high ASA class is an important risk factor for POUR among female patients, so medical staff need to provide proper preoperative management strategies for patients with a high ASA class.

Keywords: laparoscopic cholecystectomy; postoperative urinary retention.