Providing specialized orthopedic care at five convenient locations around Northeast Wisconsin. Click to find a location near you.
(920) 560-1000
Meet Our Providers Request Appointment Patient Login

FAQs about Postoperative Urinary Retention (POUR) in Joint Replacement Patients

What is Postoperative Urinary Retention (POUR)?

Postoperative urinary retention (POUR) is the inability to voluntarily urinate following surgery. This condition is common after joint replacement surgeries, such as hip or knee arthroplasties. If not promptly addressed, POUR can result in complications like urinary tract infections, delayed recovery, and bladder distension, which can impair the bladder’s ability to contract and lead to long term effects.

 

Who is at risk for developing POUR after joint replacement surgery?

Several factors can increase the risk of POUR in patients undergoing joint replacement:

  • Gender: Men are at a higher risk, particularly those with benign prostatic hyperplasia (BPH).
  • Anesthesia and Analgesia: Both spinal and general anesthesia carry risks for postoperative urinary retention in joint replacement surgeries. However, evidence suggests that spinal anesthesia, particularly when combined with opioids, may be associated with a higher incidence of POUR.
  • Age: Older patients may have a higher risk due to age-related changes in bladder function.
  • Pre-existing Conditions: Individuals with a history of urinary retention or lower urinary tract symptoms are more susceptible.
  • Post operative narcotic use: Patients taking narcotics have a higher risk of POUR.

 

How is POUR treated after joint replacement surgery?

Management of POUR involves several strategies:

  • Early ambulation: Evidence suggests that walking as soon as you are physically able after surgery can decrease the risk of POUR from 52% to 19%.
  • Warm pack: A warm pack can be placed on the lower abdomen for 20 minutes at a time.
  • Bladder Scanning: Routine use of bladder scans post-surgery can help in early detection of urinary retention, allowing for timely intervention.
  • Catheterization: If significant urinary retention is detected, catheterization may be necessary to relieve bladder distension. This can be done intermittently or with an indwelling catheter, depending on the situation.
  • Medication: In some cases, medications such as alpha-blockers (e.g., Flomax) may be used to facilitate bladder emptying by relaxing the smooth muscles of the bladder neck and prostate. The surgery center total joint nurse navigator will screen you over the phone and help determine if this is needed preoperatively.
  • Monitoring and Support: Continuous monitoring of urinary function and patient education on recognizing symptoms of urinary retention (including suprapubic pain, bladder spasms, urinary leakage and inability to urinate) are essential components of postoperative care.