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Routine Bladder Catheterisation Through Fast-track Hip and Knee Replacement - What Are the Consequences?

Completed
Conditions
Postoperative Urinary Retention
Registration Number
NCT02133768
Lead Sponsor
Lundbeck Foundation
Brief Summary

To describe the need for re-catheterization and incidence of urological complications of routine use of perioperative fixed urinary catheter (KAD) for up to 24 hours of fast-track THA and TKA

Detailed Description

Postoperative urinary retention (POUR) is a well known complication of fast-track total hip (THA) and knee arthroplasty (TKA), and even though medical options have been attempted, bladder catheterisation remains the only well-documented capacity to prevent and / or treat POUR.

It was previously standard to use fixed urinary catheter (KAD), the first 24-48 hours postoperatively to prevent POUR by THA and TKA, while more recent studies now recommend intermittent urinary catheterization in the postoperative period.

However, there are no detailed studies with adequate follow-up, describing the consequences of using either one or the other treatment regimen of POUR by fast-track THA and TKA.

Purpose:

To describe the need for re-catheterization and incidence of urological complications of routine use of perioperative fixed urinary catheter (KAD,catheter a demure) for up to 24 hours of fast-track THA and TKA

End Points:

1. The number of patients in need of re-catheterization due POUR

2. The number of patients in which the removal of KAD was not carried out within 24 hours.

3. The number of urinary tract infections from surgery to postoperative day (POD) 30

4. The number of patients with new-onset urinary discomfort at POD 30 (Increase in IPSS score).

5. The number of urological-related readmissions (including urosepsis) within POD 30

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
800
Inclusion Criteria
  • Patients must meet all the following criteria to be eligible to enroll in the study:

    • Age >50 years.
    • Patients scheduled for primary THA or TKA.
    • Patients who have given verbal consent to participate in the study.
Exclusion Criteria
  • Patients who meet one or more of the following criteria may not be included in the study:

    • Patients who can not cooperate with the study.
    • Patients who do not understand or speak Danish.
    • Patients who are permanent catheter carriers or use disposable bladder catheterisation.
    • Patients on hemodialysis.
    • Urine Derivative patients.
    • Pregnancy or childbirth within 6 months.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Number of patients needing re-catheterizationFrom removal of urinary catheter at first postoperative day and untill discharge from hospital

The need for re-catheterization will be asses on a daily basis until discharge from hospital (median 3 days from surgery)

Secondary Outcome Measures
NameTimeMethod
Number of patients who did not get their urinary catheter removed on the first postoperative daywithin the first 24 hours after surgery
Number of urinary tract infectionswithin the first 30 days after surgery

Assessed on a daily basis during admision and detailed telephone interview on day 30 after surgery

Number of patients developing postoperative micturition difficultiesFrom day 1 to day 30 after surgery

All patients completes a questionary preoperatively (the international prostate symptom score) and the same questionary again on day 30 after surgery.

Number of re-admission due to urological problems, including urosepsiswithin the first 30 days after surgery

assessed by telephone interview on day 30 after surgery

Trial Locations

Locations (1)

Department of Orthopedic

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Holstebro, Midtjylland, Denmark

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