Patients
undergoing joint replacement under epidural anaesthesia, the authors of a study
report published in the October issue of the Journal of Arthroplasty have
noted, have no increased risk for postoperative adverse genitourinary (GU)
complications by skipping preoperative indwelling urinary catheters.

Oliver J.
Scotting, M.D., from the Henry Ford Health System in Detroit, and colleagues
retrospectively reviewed data from 335 consecutive male and female patients who
underwent primary total joint arthroplasty (hip and knee) using epidural anaesthesia.
The analysis included 103 patients who received a preoperative urinary
catheter, which was maintained until the morning of the first postoperative
day, and 232 patients who did not receive a preoperative urinary catheter.

The
researchers observed no differences in the percentage of patients with
postoperative GU complications between the groups. There were no differences in
GU complications among patients with benign prostatic hyperplasia or prostate
cancer. However, the urinary tract infection rate was higher in the catheter
group among patients with a history of prostate disorders (benign prostatic
hyperplasia or prostate cancer). An association was observed between
postoperative GU complications and increased median age and increased average
length of stay.

“Until
now, we didn’t have the research to show that we could perform the surgery
without a Foley catheter,” Michael Charters, M.D., a Henry Ford joint
replacement surgeon and the study’s senior author, said in a statement.

“All
of our patients are now undergoing surgery without the catheter. It’s a huge
benefit for patients because it improves their mobility immediately after
surgery. They can get up and walk around without being impeded by catheter
tubes.”

SOURCE:  https://www.practiceupdate.com/c/90519/2/3/?elsca1=emc_enews_daily-digest&elsca2=email&elsca3=practiceupdate_uro&elsca4=urology&elsca5=newsletter&rid=NTU2MjE4MTIzNzES1&lid=10332481

REFERENCE:
Scotting et al: Indwelling Urinary Catheter for Total Joint Arthroplasty Using
Epidural Anesthesia; 
 https://www.arthroplastyjournal.org/article/S0883-5403(19)30530-3/fulltext