Spinal Anesthetic Type and Independent Risk Factors for Postoperative Urinary Retention Following Total Joint Arthroplasty


While risk factors for postoperative urinary retention (POUR) after total joint arthroplasty (TJA) have been identified, its association with type of spinal anesthetic has not yet been thoroughly investigated. Patients undergoing primary TJA between 2013–2018 were reviewed. From August 2013 to March 2016 bupivacaine was primarily given and from March 2016 through August 2018, most, although not all, received mepivacaine. Patient demographics as well as intraoperative data were recorded. One-thousand and fifty-four patients were included. POUR rates were not significantly different between groups (5.5% vs 6.1%, p = 0.675). Those who received mepivacaine had a significantly shorter length of stay (LOS) (1 vs. 2 days, p < 0.001). However, spinal anesthetic type was not significantly associated with either POUR or LOS after controlling for between-group differences. Older age (odds ratio [OR] 1.024 [95% confidence interval {CI}:1.000–1.049]; p = 0.049) and a history of benign prostatic hyperplasia or urinary incontinence/retention (OR 2.155 [95% CI:1.114–4.168]; p = 0.023) were confirmed as independent risk factors for POUR. (Journal of Surgical Orthopaedic Advances 29(4):225–229, 2020) Key words: spinal anesthesia, total joint arthroplasty, urinary retention, risk factors

Andrew W. Kuhn, MD; Jonathan R. Lynch, MD; Carolyn G. Ahlers, BS; and Gregory G. Polkowski, MD, MSc