Incidence and clinical predictors of postoperative urinary retention following total hip and total knee arthroplasty: A single-center, prospective study
Cheng En Tsai1
, Wen-hsin Tseng2, Wen-shuo Chang1, Chung-han Ho3,4, Chi-sheng Chien1
1Department of Orthopaedics, Chi Mei Medical Center, Tainan, Taiwan
2Department of Surgery, Division of Urology, Chi Mei Medical Center, Tainan, Taiwan
3Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
4Department of Information Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan
Keywords: Incidence, periprosthetic joint infection, risk factor, total hip arthroplasty, total knee arthroplasty, total joint arthroplasty, urinary retention, urinary tract infection.
Abstract
Objectives: This study aims to evaluate the incidence and clinical predictors of postoperative urinary retention (POUR) following total joint arthroplasty (TJA) and to evaluate whether preoperative bladder voiding efficiency (BVE) can independently predict POUR.
Patients and methods: Between September 2023 and May 2024, a total of 200 patients (66 males, 134 females; median age: 69 years; range, 32 to 90 years) scheduled for primary total hip or knee arthroplasty were prospectively analyzed. Patients were classified into POUR (n=33) and non-POUR (n=167) groups. Demographic characteristics, urological history, operative variables, the International Prostate Symptom Scores (IPSS), and bladder scanner measurements were collected and compared.
Results: The overall incidence of POUR was 16.5% (33/200). Compared to the non-POUR group, the POUR group exhibited significantly higher IPSS (p<0.001) and lower BVE (p=0.0016). Higher body mass index (p<0.001), hypertension (p<0.001), and diabetes mellitus (p<0.001) were significantly associated with POUR development.
Conclusion: Higher preoperative IPSS and lower BVE seem to be independently associated with POUR following TJA. Notably, BVE emerges as a novel and clinically meaningful predictor. Routine preoperative assessment of BVE and IPSS may aid in the early identification of high-risk patients, enabling the implementation of targeted strategies to prevent POUR and its associated complications.
Citation: Tsai CE, Tseng WH, Chang WS, Ho CH, Chien CS. Incidence and clinical predictors of postoperative urinary retention following total hip and total knee arthroplasty: A singlecenter, prospective study. Jt Dis Relat Surg 2026;37(1):98-106. doi: 10.52312/jdrs.2026.2429.