Postoperative urinary retention in gynecologic patients

The aim of this study was to determine the prevalence of postoperative urinary retention (PU) based on preoperative estimation of bladder capacity in gynecologic patients and to evaluate the reliability of clinical examination in diagnosing PU. Over a 3-year period 284 consecutive patients undergoing surgical intervention were included in the study. Bladder capacity was assessed preoperatively. If PU was suspected a clinical examination, bladder scan and catheterization were performed. The prevalence of postoperative urinary retention was 9.2%. There was a significant association between PU and the type of operation, but not with the type or the duration of anesthesia or total blood loss. Clinical examination was reliable, with a positive and negative predictive value of 76.2% and 100%, respectively. In conclusion, PU is a substantial problem after gynecologic surgery. Patients at risk are difficult to predict. The risk is higher after laparotomy than after laparoscopy. The clinical diagnosis is fairly accurate.