Postoperative urinary retention (POUR) is among the reasons for delay in discharge after outpatient total hip arthroplasty, occurring in from 2% to 46% of patients. We hypothesized that the frequency of POUR following outpatient total hip arthroplasty in the ASC is low compared to previously reported rates and that management can be effective in the perioperative period when it is encountered.

Three hundred and seventy-seven total hip arthroplasty (THA) patients (409 hips) who had arthroplasties in the ambulatory surgery center over a 5-year period were identified. Preoperatively, appropriate demographic information and medical co-morbidities were collected from patient health history questionnaires completed during clinic visits. Intraoperatively, albumin volume administered and estimated blood loss (EBL) were recorded. Postoperatively, post-anesthesia care unit (PACU) medications, patients who reported an inability to urinate, and those who required urinary catheterization were recorded.

POUR occurred in only two patients but complaints of the inability to void occurred in 38 others for an incidence of 9.8%. Factors associated with POUR and the inability to urinate included older age, time spent in the ASC, and intraoperatively albumin volume administered. No significant differences were found in BMI, preoperative hematocrit, estimated blood loss, surgical time, or operating time.

POUR was infrequent but the reported inability to urinate was not (9.8%) and can be safely managed when it does occur and we found that increased age and albumin volume over 500ml may increase the risk for a prolonged length of stay due to the inability to urinate.