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Systematic review of interventions for the prevention and treatment of postoperative urinary retention

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Systematic review of interventions for the prevention and treatment of postoperative urinary retention. / Jackson, Joni; Davies, Philippa; Leggett, Nick; Nugawela Pathirannehelage, Manjula; Scott, Lauren; Leach, Verity; Richards, Alison; Blacker, Anthony; Abrams, Paul; Sharma, Jitin; Donovan, Jenny; Whiting, Penny.

In: BJS Open, Vol. 3, No. 1, 02.2019, p. 11-23.

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Jackson, J, Davies, P, Leggett, N, Nugawela Pathirannehelage, M, Scott, L, Leach, V, Richards, A, Blacker, A, Abrams, P, Sharma, J, Donovan, J & Whiting, P 2019, 'Systematic review of interventions for the prevention and treatment of postoperative urinary retention', BJS Open, vol. 3, no. 1, pp. 11-23. https://doi.org/10.1002/bjs5.50114

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Jackson, Joni ; Davies, Philippa ; Leggett, Nick ; Nugawela Pathirannehelage, Manjula ; Scott, Lauren ; Leach, Verity ; Richards, Alison ; Blacker, Anthony ; Abrams, Paul ; Sharma, Jitin ; Donovan, Jenny ; Whiting, Penny. / Systematic review of interventions for the prevention and treatment of postoperative urinary retention. In: BJS Open. 2019 ; Vol. 3, No. 1. pp. 11-23.

Bibtex

@article{9a0d0d0452e843bca37cc09c36e7d888,
title = "Systematic review of interventions for the prevention and treatment of postoperative urinary retention",
abstract = "Background:Postoperative urinary retention (PO-UR) is an acute and painful inability to void aftersurgery that can lead to complications and delayed hospital discharge. Standard treatment with a urinarycatheter is associated with a risk of infection and can be distressing, undignified and uncomfortable. Thissystematic review aimed to identify effective interventions for the prevention and treatment of PO-URthat might be alternatives to urinary catheterization.Methods:Electronic databases were searched from inception to September 2017. Randomized trialsof interventions for the prevention or treatment of PO-UR were eligible for inclusion. Studies wereassessed for risk of bias using the Cochrane (2.0) tool. Two reviewers were involved at all review stages.Where possible, data were pooled using random-effects meta-analysis. The overall quality of the bodyof evidence was rated using the GRADE approach.Results:Some 48 studies involving 5644 participants were included. Most interventions were pharma-cological strategies to prevent PO-UR. Based on GRADE, there was high-certainty evidence to supportreplacing morphine in a regional anaesthetic regimen, using alpha-blockers (number needed to treatto prevent one case of PO-UR (NNT) 5, 95 per cent c.i. 5 to 7), the antispasmodic drug drotaverine(NNT 9, 7 to 30) and early postoperative mobilization (NNT 5, 4 to 8) for prevention, and employ-ing hot packs or gauze soaked in warm water for treatment (NNT 2, 2 to 4). Very few studies reportedon secondary outcomes of pain, incidence of urinary tract infection or duration of hospital stay.Conclusion:Promising interventions exist for PO-UR, but they need to be evaluated in randomized trialsinvestigating comparative clinical and cost effectiveness, and acceptability to patients.",
author = "Joni Jackson and Philippa Davies and Nick Leggett and {Nugawela Pathirannehelage}, Manjula and Lauren Scott and Verity Leach and Alison Richards and Anthony Blacker and Paul Abrams and Jitin Sharma and Jenny Donovan and Penny Whiting",
year = "2019",
month = "2",
doi = "10.1002/bjs5.50114",
language = "English",
volume = "3",
pages = "11--23",
journal = "BJS Open",
issn = "2474-9842",
publisher = "Wiley",
number = "1",

}

RIS - suitable for import to EndNote

TY - JOUR

T1 - Systematic review of interventions for the prevention and treatment of postoperative urinary retention

AU - Jackson, Joni

AU - Davies, Philippa

AU - Leggett, Nick

AU - Nugawela Pathirannehelage, Manjula

AU - Scott, Lauren

AU - Leach, Verity

AU - Richards, Alison

AU - Blacker, Anthony

AU - Abrams, Paul

AU - Sharma, Jitin

AU - Donovan, Jenny

AU - Whiting, Penny

PY - 2019/2

Y1 - 2019/2

N2 - Background:Postoperative urinary retention (PO-UR) is an acute and painful inability to void aftersurgery that can lead to complications and delayed hospital discharge. Standard treatment with a urinarycatheter is associated with a risk of infection and can be distressing, undignified and uncomfortable. Thissystematic review aimed to identify effective interventions for the prevention and treatment of PO-URthat might be alternatives to urinary catheterization.Methods:Electronic databases were searched from inception to September 2017. Randomized trialsof interventions for the prevention or treatment of PO-UR were eligible for inclusion. Studies wereassessed for risk of bias using the Cochrane (2.0) tool. Two reviewers were involved at all review stages.Where possible, data were pooled using random-effects meta-analysis. The overall quality of the bodyof evidence was rated using the GRADE approach.Results:Some 48 studies involving 5644 participants were included. Most interventions were pharma-cological strategies to prevent PO-UR. Based on GRADE, there was high-certainty evidence to supportreplacing morphine in a regional anaesthetic regimen, using alpha-blockers (number needed to treatto prevent one case of PO-UR (NNT) 5, 95 per cent c.i. 5 to 7), the antispasmodic drug drotaverine(NNT 9, 7 to 30) and early postoperative mobilization (NNT 5, 4 to 8) for prevention, and employ-ing hot packs or gauze soaked in warm water for treatment (NNT 2, 2 to 4). Very few studies reportedon secondary outcomes of pain, incidence of urinary tract infection or duration of hospital stay.Conclusion:Promising interventions exist for PO-UR, but they need to be evaluated in randomized trialsinvestigating comparative clinical and cost effectiveness, and acceptability to patients.

AB - Background:Postoperative urinary retention (PO-UR) is an acute and painful inability to void aftersurgery that can lead to complications and delayed hospital discharge. Standard treatment with a urinarycatheter is associated with a risk of infection and can be distressing, undignified and uncomfortable. Thissystematic review aimed to identify effective interventions for the prevention and treatment of PO-URthat might be alternatives to urinary catheterization.Methods:Electronic databases were searched from inception to September 2017. Randomized trialsof interventions for the prevention or treatment of PO-UR were eligible for inclusion. Studies wereassessed for risk of bias using the Cochrane (2.0) tool. Two reviewers were involved at all review stages.Where possible, data were pooled using random-effects meta-analysis. The overall quality of the bodyof evidence was rated using the GRADE approach.Results:Some 48 studies involving 5644 participants were included. Most interventions were pharma-cological strategies to prevent PO-UR. Based on GRADE, there was high-certainty evidence to supportreplacing morphine in a regional anaesthetic regimen, using alpha-blockers (number needed to treatto prevent one case of PO-UR (NNT) 5, 95 per cent c.i. 5 to 7), the antispasmodic drug drotaverine(NNT 9, 7 to 30) and early postoperative mobilization (NNT 5, 4 to 8) for prevention, and employ-ing hot packs or gauze soaked in warm water for treatment (NNT 2, 2 to 4). Very few studies reportedon secondary outcomes of pain, incidence of urinary tract infection or duration of hospital stay.Conclusion:Promising interventions exist for PO-UR, but they need to be evaluated in randomized trialsinvestigating comparative clinical and cost effectiveness, and acceptability to patients.

U2 - 10.1002/bjs5.50114

DO - 10.1002/bjs5.50114

M3 - Article

C2 - 30734011

VL - 3

SP - 11

EP - 23

JO - BJS Open

JF - BJS Open

SN - 2474-9842

IS - 1

ER -