The Hidden Barrier to Going Home: Solving Urinary Retention After Joint Surgery

A new study reveals which catheterization method gets patients home safely with fewer complications.

Postoperative urinary retention (POUR) after primary hip and knee total joint arthroplasty (TJA) ranges from 4% to 46%. POUR is associated with urological injury and urinary tract infection (UTI) with possible hematogenous periprosthetic joint infection. Because of these risks, and the fact that a patient cannot be safely sent home until they can void, POUR is a common barrier to rapid-discharge TJA.

When a patient experiences POUR, the clinical team must intervene. Consequently, catheterization with an indwelling catheter, treatment with intermittent catheterization, or both are routinely used. However, the choice is driven by provider preference, with both methods associated with undesirable consequences, including increased infection risk, discomfort and pain, and compromised dignity. We wanted to look at the hard data to determine which method is actually the safest and most effective for getting our patients home.