Patient-related risk factors for urinary retention following ambulatory general surgery: a systematic review and meta-analysis

BACKGROUND: Postoperative urinary retention (POUR) is a source of avoidable patient harm. The aim of this review is to identify and quantify the role of patient-related risk factors in the development of POUR following ambulatory general surgery. METHODS: Studies published until December 2014 were identified by searching MEDLINE, EM-BASE, and PsycINFO databases. Risk factors assessed in 3 or more studies were meta-analyzed. RESULTS: Twenty-one studies were suitable for inclusion consisting of 7,802 patients. The incidence of POUR was 14%. Increased age and the presence of lower urinary tract symptoms significantly increased risk with odds ratios [ORs] of 2.11 (95% confidence interval [CI] 1.15 to 3.86) and 2.83 (1.57 to 5.08), respectively. Male sex was not associated with developing POUR (OR.96, 95% CI .62 to 1.50). Preoperative alpha-blocker use significantly decreased the incidence of POUR with an OR of .37 (95% CI .15 to .91). CONCLUSIONS: Increased age and the presence of lower urinary tract symptoms increase the risk of POUR, while a-blocker use confers protection. Male sex was not associated with POUR. These findings assist in preoperative identification of patients at high risk of POUR. (C) 2015 Elsevier Inc. All rights reserved.