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Ear, Nose, & Throat Journal Jan 2024Postoperative urinary retention (POUR) is influenced by many factors, and its reported incidence rate varies widely. This study aimed to investigate the occurrence and...
OBJECTIVES
Postoperative urinary retention (POUR) is influenced by many factors, and its reported incidence rate varies widely. This study aimed to investigate the occurrence and risk factors for urinary retention following general anesthesia for endoscopic nasal surgery in male patients aged >60 years.
METHODS
A retrospective review of medical records between January 2015 and December 2019 identified 253 patients for inclusion in our study. Age, body mass index (BMI), a history of diabetes/hypertension, American Society of Anesthesiologists (ASA) classification, and urologic history were included as patient-related factors. Urologic history was subdivided into 3 groups according to history of benign prostate hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and current medication. The following was analyzed as perioperative variables for POUR development: duration of anesthesia and surgery; amount of fluid administered; rate of fluid administration; intraoperative requirement for fentanyl, ephedrine, and dexamethasone; postoperative pain; and analgesic use. Preoperatively measured prostate size and uroflowmetry parameters of patients on medication for symptoms were compared according to the incidence of urinary retention.
RESULTS
Thirty-seven (15.7%) patients developed POUR. Age (71.4 vs 69.6 years), BMI (23.9 vs 24.9 kg/m), a history of diabetes/hypertension, ASA classification, and perioperative variables were not significantly different between patients with and without POUR. Only urologic history was identified as a factor affecting the occurrence of POUR ( = .03). The incidence rate among patients without urologic issues was 5.9%, whereas that among patients with BPH/LUTS history was 19.8%. Among patients taking medication for symptoms, the maximal and average velocity of urine flow were significantly lower in patients with POUR.
CONCLUSIONS
General anesthesia for endoscopic nasal surgery may be a potent trigger for urinary retention in male patients aged >60 years. The patient's urological history and urinary conditions appear to affect the occurrence of POUR.
Topics: Humans; Male; Urinary Retention; Retrospective Studies; Prostatic Hyperplasia; Diabetes Mellitus; Risk Factors; Postoperative Complications; Nasal Surgical Procedures; Hypertension; Anesthesia, General
PubMed: 34281423
DOI: 10.1177/01455613211033112 -
Ear, Nose, & Throat Journal Sep 2023The most common cause of cerebrospinal fluid (CSF) rhinorrhoea is damage to the skull base with a dura mater's rupture due to an accident or an iatrogenic injury. This...
The most common cause of cerebrospinal fluid (CSF) rhinorrhoea is damage to the skull base with a dura mater's rupture due to an accident or an iatrogenic injury. This applies to over 96% of cases. Other possibilities that can lead to CSF leakage are neoplasms of the nasal cavity, paranasal sinuses, and nasopharynx. Although prostate cancer spreads to bones, cranial metastases to paranasal sinuses are extremely rare. We present a case of an 83-year-old patient with CSF leakage due to infiltrating metastatic prostate cancer. Cerebrospinal fluid rhinorrhea turned out to be the first symptom of prostate cancer metastasis. Diagnostic and treatment strategies are presented in the discussion.
Topics: Male; Humans; Aged, 80 and over; Cerebrospinal Fluid Rhinorrhea; Prostate; Skull Base; Cerebrospinal Fluid Leak; Prostatic Neoplasms; Adenocarcinoma
PubMed: 34037491
DOI: 10.1177/01455613211016710