#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Urethral catheter as a risk factor of urologic complications after total knee arthoplasty – the retrospective analysis


Authors: J. Hrubinová 1;  M. Hrubina 2;  J. Pangrác 1
Authors‘ workplace: Urologické oddělení Nemocnice Pelhřimov, primář: MUDr. Jaromír Pangrác 1;  Ortopedické oddělení Pelhřimov, vedením oddělení pověřen: MUDr. Miroslav Skoták 2
Published in: Rozhl. Chir., 2012, roč. 91, č. 1, s. 12-17.
Category: Original articles

Overview

Introduction:
In the literature, there are only few articles about urologic complications after total knee arthroplasty. We have evaluated our group of patients focusing on urethral catheter as a risk factor for urologic complications after the replacement.

Material and Method:
We have evaluated a group of 236 patients (143 female and 93 male subjects) aged 71.3 years on average, after primary total knee arthroplasty in 2008–2009, focusing on urologic complications of the patients. Permanent catheter was introduced in all the subjects after the operation. The group of patients was evaluated at end of 2010. We have evaluated urologic complications, the period of time the catheter was in place and analyzed the risk factors one year after the operation.

Results:
The incidence of urologic complications is 19.4% in men and 6.3% in women. The average duration of catheterization was 4 days, and 7 days in patients with complications. 126 patients (53.4%) had their catheter introduced for up to 4 days, out of whom complications occured in 5 (4%) patients. 110 patients (46.4%) were catheterized for over 4 days, and in this subgroup, complication occured in 23 (21%) subjects. IPSS is 8, on average, in complications 12/35, on average. A total of 5 patients were unsatisfied (2.1%). The combination of male gender with catheterization for over 4 days, is the main risk factor for urologic complications.

Conclusion:
In the literature the authors found only several articles related to urologic complications after the knee arthroplasty focused on postoperative urinary retention and the catheter. The risk factor is increased duration of catheterization , male gender and, partially, positive urologic anamnesis. There is a posibility to use „safe catheter“ in the risky patients in future.

Key words:
urologic complications of treatment – knee arthroplasty


Sources

1. Vavřík P, Landor I, Tomaides J, et al. Střednědobé výsledky u náhrad kolenního kloubu Medin Modular. Acta Chir Orthop Traumatol Cech 2009;76:30–34.

2. Jahoda D, Nyč O, Šimša J, et al. Pozdní hematogenní infekce kloubních náhrad. Acta Chir Orthop Traumatol Cech 2008;75:88–92.

3. Tomáš T. Pacient – rizikový faktor infekce totální endoprotézy. Acta Chir Orthop Traumatol Cech 2008;75:451-456.

4. Ženíšek J. Striktury uretry. Urolog pro Praxi 2002;2:67–69.

5. Hrubina M, Skoták M, Běhounek J. Komplikace operační léčby zlomenin proximálního femuru metodou DHS. Acta Chir Orthop Traumatol Cech 2010;77:395–401.

6. Frank M, Dědek T, Broďák M. Ošetření ruptury močového měchýře při zlomenině pánve bez epicystostomie – kazuistika. Rozhl Chir 2011;4:226–228.

7. Džupa V, Chmelová J, Pavelka T, et al. Multicentrická studie pacientů s poraněním pánve: základní analýza souboru. Acta Chir Orthop Traumatol Cech 2009;76:404–409.

8. Chmelová J, Džupa V, Pleva L. Role zobrazovacích metod v diagnostice poranění pánve. Acta Chir Orthop Traumatol Cech 2008;75:93–98.

9. Jamsen E, Huhtala H, Puolakka T, et al. Risk factors for infection after knee arthroplasty. J Bone Joint Surg 2009; 91-A:38–47.

10. Kotwal R, Hodgson P, Carpenter C. Urinary retention following lower limb arthroplasty: analysis of predictive factors and review of literature. Acta Orthop Belg 2008; 74: 332–336.

11. Míka P, Hrubina M. Zkušenosti s podáváním bemiparinu na ortopedickém oddělení. Bemiparin Update 11, 2011;1:5–6.

12. Míka P, Běhounek J, Skoták M, et al. Komplikace a rizika profylaktické antikoagulační léčby prováděné kombinací nízkomolekulárního heparinu (LMWH) a Warfarinu po implantaci TEP velkých kloubů – naše zkušenosti. Acta Chir Orthop Traumatol Cech 2004;71:237–244.

13. Kočvara R. Poranění mužské uretry – časné a odložené řešení. Urol List 2005;3:26–31.

14. Balderi T, Carli F. Urinary retention after total hip and knee arthroplasty. Minerva Anestesiol 2010;76:120–130.

15. Baldini G, Bagry H, Aprikian A, et al. Postoperative urinary retention: anesthetic and perioperative considerations. Anesthesiology 2009;5:1139–1157.

16. Van den Brand IC, Castelein RM. Total joint arthroplasty and incidence of postoperative bacteriuria with an indwelling catheter of intermitent catheterization with one-dose antibiotic prophylaxis: a prospective randomized trial. J Arthroplasty 2001;16:850–855.

17. Izard J P, Sowery RD, Jaeger MT, et al. Parameters affecting urologic complications after major joint replacement surgery. Can J Urol 2006;13:3158–3163.

18. Macek P. Komplikované infekce močových cest. Urolog pro Praxi 2010;11:302–307.

19. Broďák M, Košina J, Holub L, et al. Antibiotická profylaxe v urologii. Urolog pro Praxi 2010;11:97–100.

20. Stenzelius K, Persson S, Olsson UB, et al. Noble metal alloy-coated late versus silicone foley catheter short-term catheterization: a randomized controlled study. Scand J Urol Nephrol 2011;3: 31.

Labels
Surgery Orthopaedics Trauma surgery
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#