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Postoperativ urinretensjon

Sist revidert:
Sist revidert av:

Definisjon:
Manglende evne til å tømme urinblæren etter et kirurgisk inngrep. Anestesi og (opiat-) analgesi er trolig viktigste årsak
Forekomst:
En rekke faktorer påvirker risikoen for retensjon. Insidensen er i området 10-20%, og øker i takt med kompleksiteten av inngrepet
Symptomer:
Overdistensjon av urinblæren kan gi pasienten ubehag og smerter, men dette maskeres gjerne av postoperativ smertelindring. Kardiovaskulære reaksjoner kan oppstå som respons på retensjon
Funn:
Palpasjon/perkusjon av blæren er ikke pålitelig nok i seg selv
Diagnostikk:
Ultralyd gir sikker og brukervennlig diagnostikk
Behandling:
Overvåkning med tidlig diagnostikk/avlastning (kateterisering) reduserer risikoen for vedvarende komplikasjoner i form av blæretømmingsforstyrrelser. Prognosen er god ved tidlig behandling
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  2. Baldini G, Bagry H, Aprikian A, Carli F. Postoperative urinary retention: anesthetic and perioperative considerations. Anesthesiology 2009; 110: 1139-57. PubMed  
  3. Olsen SW, Nielsen J. A Study into Postoperative Urine Retention in the Recovery Ward. British Journal of Anaesthetic and Recovery Nursing 2007; 8: 91-5. PubMed  
  4. Keita H, Diouf E, Tubach F, et al. Predictive factors of early postoperative urinary retention in the postanesthesia care unit. Anesth Analg 2005; 101: 592-6. PubMed  
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  6. Koch CA, Grinberg GG, Farley DR. Incidence and risk factors for urinary retention after endoscopic hernia repair. Am J Surg 2006; 191: 381-5. PubMed  
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  11. Sarasin SM, Walton MJ, Singh HP, Clark DI. Can a urinary tract symptom score predict the development of postoperative urinary retention in patients undergoing lower limb arthroplasty under spinal anaesthesia? A prospective study.. Ann R Coll Surg Engl 2006; 88: 394-8. PubMed  
  12. Smorgick N, DeLancey J, Patzkowsky K, et al. Risk factors for postoperative urinary retention after laparoscopic and robotic hysterectomy for benign indications. Obstet Gynecol 2012; 120: 581-6. PubMed  
  13. Mentler E, Mann K, Earley A, Lucha P. High incidence of acute urinary retention associated with immediate catheter removal after laparoscopic Nissen fundoplication. Surg Endosc 2011; 25: 1611-6. PubMed  
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  16. Dolin SJ, Cashman JN. Tolerability of acute postoperative pain management: nausea, vomiting, sedation, pruritus, and urinary retention. Evidence from published data. Br J Anaesth 2005; 95: 584-91. PubMed  
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  18. Toyonaga T, Matsushima M, Sogawa N, et al. Postoperative urinary retention after surgery for benign anorectal disease: potential risk factors and strategy for prevention. Int J Colorectal Dis 2006; 21: 676-82. PubMed  
  19. 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: 332-6. PubMed  
  20. Management of bladder function after outpatient surgery. Pavlin DJ, Pavlin EG, Fitzgibbon DR, et al. Management of bladder function after outpatient surgery. Anesthesiology 1999; 91: 42-50. PubMed  
  21. Madeiro AP, Rufino AC, Sartori MG, et al. The effects of bethanechol and cisapride on urodynamic parameters in patients undergoing radical hysterectomy for cervical cancer. A randomized, double-blind, placebo-controlled study. Int Urogynecol J Pelvic Floor Dysfunct 2006; 17: 248-52. PubMed  
  22. Lusardi G, Lipp A, Shaw C. Antibiotic prophylaxis for short-term catheter bladder drainage in adults. Cochrane Database Syst Rev 2013 Jul 3;7:CD005428. PMID: 23824735. PubMed  
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Steinar J. Karlsen, tidligere klinikksjef og professor dr. med., Oslo Urologiske Universitetsklinikk, Aker universitetssykehus helseforetak og Universitetet i Oslo
  • Leiv Arne Rosseland, assistentlege, Anestesiavdelingen, Rikshospitalet, Oslo