Urinary Difficulty After General Anesthesia for Otolaryngology Head and Neck Surgery

BackgroundPostoperative urinary difficulty (POUD) is a common complication following surgery under general anesthesia. This study aims to evaluate the prevalence of and identify the risk factors associated with POUD in patients undergoing otolaryngology head and neck surgery.MethodsWe retrospectively reviewed the medical records of consecutive patients who underwent otolaryngology head and neck surgery under general anesthesia between July 2020 and September 2020. Patients complaining of POUD were evaluated using an automatic portable bladder ultrasound scanner to assess bladder distension and urine volume. The prevalence and clinical characteristics of POUD were analyzed.ResultsA total of 680 patients were enrolled (417 males, 61%; 263 females, 39%), with a mean age of 52 years. The overall prevalence of POUD was 14.1%, with a mean urine volume of 449 ml. Male gender was the independent risk factor of POUD, with males (18%) more common than females (8%). Age and operation time were also the independent risk factors of POUD. The prevalence of POUD increased significantly with age in males (p<0.001) but no significant association was observed in females (p=0.687). Notably, POUD occurred in 23% of males over 50 years old and 46% of those over 70. Patients with rocuronium plus neostigmine had the highest risk for POUD (43%). No patients with rocuronium plus sugammadex had POUD.ConclusionsPOUD is common following otolaryngology head and neck surgery, particularly in older male patients and with prolonged operation time. It is essential to develop targeted interventional strategies to prevent and manage POUD in these high-risk groups.